Individual provider Active NPI

Jenna Lerae Welton, APRN

  • Critical Care Pediatric Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1780413724
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X
License
115504 Issued in NE
Practice address
4350 Dewey Ave
Omaha, NE 68105-1017
Phone
(402) 552-2000
NPI assigned
Jul 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Pediatric Nurse Practitioner 363LP0222X 115504 NE Primary

Addresses

Primary practice location

4350 Dewey Ave
Omaha, NE 68105-1017

Mailing address

6514 S 167TH Ave
Omaha, NE 68135-5403
Phone (402) 238-4879

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241009000794 NE Practitioner - Nurse Practitioner 4688105000 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Unmc Physicians CurrentSince Sep 5, 2024 Accepting new patients

Locations

4350 Dewey Ave
Omaha, NE 68105
Phone (402) 552-2552

988102 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-5600

987400 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-3405

Emile 42nd St
Omaha, NE 68198
Phone (402) 552-6731

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1722211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1780413724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6514 S 167TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681355403",
            "telephone_number": "402-238-4879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 DEWEY AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681051017",
            "telephone_number": "402-552-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELTON",
        "first_name": "JENNA",
        "middle_name": "LERAE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-29",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "NE",
            "license": "115504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.