NPIMap

Organization Active NPI

Omaha VA Hospital

  • Primary Care Clinic/Center
  • Omaha, NE
National Provider Identifier
1780969824
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
26112 Issued in NE
Legal business name
OMAHA VA HOSPITAL
Practice address
4101 Woolworth Ave
Omaha, NE 68105-1850
Phone
(402) 346-8800
NPI assigned
Oct 20, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

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

Authorized official

Name
Dr. Mary B Tadros, M.D.
Title
Physician
Phone
(402) 346-8800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 26112 NE Primary
General Acute Care Hospital 282N00000X 26112 NE

Addresses

Primary practice location

4101 Woolworth Ave
Omaha, NE 68105-1850

Mailing address

2706 N 96TH Dr
Omaha, NE 68134-5652
Phone (402) 517-2648

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319068800000",
    "number": "1780969824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2706 N 96TH DR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681345652",
            "telephone_number": "402-517-2648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 WOOLWORTH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681051850",
            "telephone_number": "402-346-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMAHA VA HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-20",
        "last_updated": "2011-10-20",
        "status": "A",
        "authorized_official_last_name": "TADROS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "402-346-8800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NE",
            "license": "26112",
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NE",
            "license": "26112",
            "primary": false
        }
    ],
    "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 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.