Active NPI
Pure Infusion of Nebraska LLC
- Multi-Specialty Clinic/Center
- Omaha, NE
National Provider Identifier
1760364145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Multi-Specialty Clinic/Center
- Legal business name
- PURE INFUSION OF NEBRASKA LLC
- Practice address
- 3125 N 120TH St
Omaha, NE 68164-2527 - Phone
- (402) 281-0880
- NPI assigned
- Jul 24, 2025
- Last updated
- Oct 7, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rachel Fraga
- Title
- Director of Payer Deveolopment
- Phone
- (801) 921-6325
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infusion Therapy Clinic/Center | 261QI0500X | NU | ||
| Multi-Specialty Clinic/Center | 261QM1300X | NU | Primary |
Addresses
Primary practice location
3125 N 120TH St
Omaha, NE 68164-2527
Mailing address
4179 S Riverboat Rd Ste 220
Taylorsville, UT 84123-2986
Phone (801) 590-9267
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
3125 N 120th St
Omaha, NE 68164
Phone (402) 281-0880
Practitioners & affiliated clinicians
Practitioners 6
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.
-
- Primary Care Nurse Practitioner
- Omaha, NE
- NPI 1487915559
-
- Vascular Neurology Physician
- Jacksonville Beach, FL
- NPI 1093073181
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1753315200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1759795200000",
"number": "1760364145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4179 S RIVERBOAT RD STE 220",
"city": "TAYLORSVILLE",
"state": "UT",
"postal_code": "841232986",
"telephone_number": "801-590-9267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3125 N 120TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681642527",
"telephone_number": "402-281-0880"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PURE INFUSION OF NEBRASKA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-07-24",
"last_updated": "2025-10-07",
"certification_date": "2025-10-07",
"status": "A",
"authorized_official_last_name": "FRAGA",
"authorized_official_first_name": "RACHEL",
"authorized_official_title_or_position": "DIRECTOR OF PAYER DEVEOLOPMENT",
"authorized_official_telephone_number": "801-921-6325"
},
"taxonomies": [
{
"code": "261QI0500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Infusion Therapy",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; 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.