NPIMap

Organization Active NPI

Alivation Health, LLC

  • Psychiatry Physician
  • Lincoln, NE
National Provider Identifier
1710917448
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
ALIVATION HEALTH, LLC
Practice address
8550 Cuthills Circle
Lincoln, NE 68526-9467
Phone
(402) 476-6060
Fax
(402) 476-6809
NPI assigned
Jul 5, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Walter J. Duffy, M.D.NPI 1093853368
Title
Owner/Ceo
Phone
(402) 476-6060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU
Family Medicine Physician 207Q00000X NU
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

8550 Cuthills Circle
Lincoln, NE 68526-9467

Mailing address

8550 Cuthills Circle
Lincoln, NE 68526-9467
Phone (402) 476-6060

Other identifiers 2

IdentifierTypeStateIssuer
098936OtherNEPTAN
10025071300MedicaidNE

Other names 1

  • Premier Psychiatric Group, LLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040311001200 NE Part B Supplier - Clinic/Group Practice 0941199681 Receives reassigned benefits from 42 practitioners
Practice locations: Columbus, NE; Lincoln, NE; Grand Island, NE

National Provider Directory

National Provider Directory

Locations

2221 S 17th St
#205
Lincoln, NE 68502

5539 S 27th St
Ste 206
Lincoln, NE 68512
Phone (402) 423-3600

8550 Cuthills Cir
Ste 100
Lincoln, NE 68526

17021 Lakeside Hills Plz
Ste 201
Omaha, NE 68130
Phone (402) 506-6335

Practitioners & affiliated clinicians

Practitioners 85

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 85

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1710917448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8550 CUTHILLS CIRCLE",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685269467",
            "telephone_number": "402-476-6060",
            "fax_number": "402-476-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 CUTHILLS CIRCLE",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685269467",
            "telephone_number": "402-476-6060",
            "fax_number": "402-476-6809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALIVATION HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DUFFY",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "402-476-6060",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "098936",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025071300",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Psychiatric Group, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Premier Psychiatric Group, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.