Individual provider Active NPI

Emily Jane Payne, APRN

  • Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1720831381
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
115254 Issued in NE
Practice address
312 S 15TH St
Omaha, NE 68102-2207
Phone
(402) 354-2273
Fax
(402) 815-9745
NPI assigned
Apr 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 115254 NE Primary

Addresses

Primary practice location

312 S 15TH St
Omaha, NE 68102-2207

Mailing address

PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-5677

Other names 1

  • Emily Jane Rollag Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240708000396 NE Practitioner - Nurse Practitioner 3870037427 Reassigns benefits to 1 organization
I20241118002991 IA Practitioner - Nurse Practitioner 3870037427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians

Practice addresses (Care Compare)

312 S 15TH St
Omaha, NE 68102-2207
Phone (402) 354-2273

808 E Pierce St
Methodist Physicians Clinic
Council Bluffs, IA 51503-4652
Phone (712) 396-4360

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
115254NEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Clinic Inc Nurse Practitioner CurrentSince Jun 30, 2024 Accepting new patients
Nebraska Methodist Hospital Current Accepting new patients

Locations

1 Edmundson Pl
Ste 310
Council Bluffs, IA 51503
Phone (712) 328-1801

1 Edmundson Pl
Council Bluffs, IA 51503
Phone (712) 396-4000

808 E Pierce St
Council Bluffs, IA 51503
Phone (712) 396-4340

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

312 S 15th St
Omaha, NE 68102
Phone (402) 354-2273

825 S 169th St
Fl 3
Omaha, NE 68118
Phone (402) 354-5451

Interoperability endpoints

  • Direct secure messaging: emily.payne@direct.nmhs.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1712793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1720831381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 S 15TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681022207",
            "telephone_number": "402-354-2273",
            "fax_number": "402-815-9745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "EMILY",
        "middle_name": "JANE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-11",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "115254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "ROLLAG",
            "middle_name": "JANE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.