Individual provider Active NPI

Ian Micheal Pierce, APRN

  • Family Nurse Practitioner
  • Papillion, NE
National Provider Identifier
1790452977
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
113771 Issued in NE
Practice address
529 Pinnacle Dr
Papillion, NE 68046-6242
Phone
(402) 268-1212
Fax
(402) 502-9177
NPI assigned
Aug 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 113771 NE
Family Nurse Practitioner 363LF0000X 113771 NE Primary

Addresses

Primary practice location

529 Pinnacle Dr
Papillion, NE 68046-6242

Mailing address

529 Pinnacle Dr
Papillion, NE 68046-6242
Phone (402) 268-1212

Other practice location 1

14404 Stoney Brook Blvd
Omaha, NE 68137-2613
Phone (402) 979-9635

Other identifiers 1

IdentifierTypeStateIssuer
113771OtherNEAPRN STATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, NE2 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
I20220411000618 IA Practitioner - Nurse Practitioner 5991191496
I20220411000666 NE Practitioner - Nurse Practitioner 5991191496 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Florida International Univ, College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Clinicians Associates, LLCGroup PAC ID 3476511619, 15 clinicians

Practice addresses (Care Compare)

6901 N 72ND St
Omaha, NE 68122-1709
Phone (402) 572-2121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
113771NEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New Century Physicians of Nebraska LLC CurrentSince Jan 8, 2022 Accepting new patients
Emergency Clinicians Associates, LLC Nurse Practitioner CurrentSince Oct 1, 2022 Accepting new patients
New Century Physicians of Nebraska LLC Current Accepting new patients
New Century Physicians of Iowa PC CurrentSince Jan 8, 2022 Accepting new patients

Locations

800 Mercy Dr
Council Bluffs, IA 51503
Phone (712) 328-5000

16901 Lakeside Hills Ct
Omaha, NE 68130
Phone (402) 572-6500

6901 N 72nd St
Omaha, NE 68122
Phone (402) 572-2121

11111 S 84th St
Papillion, NE 68046
Phone (402) 593-3000

265 Brookview Centre Way
Ste 400
Knoxville, TN 37919
Phone (865) 293-5549

Organizations & group practices 4

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": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1790452977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 PINNACLE DR",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680466242",
            "telephone_number": "402-268-1212",
            "fax_number": "402-502-9177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 PINNACLE DR",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680466242",
            "telephone_number": "402-268-1212",
            "fax_number": "402-502-9177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14404 Stoney Brook Blvd",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681372613",
            "country_code": "US",
            "telephone_number": "402-979-9635",
            "fax_number": "402-895-9636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIERCE",
        "first_name": "IAN",
        "middle_name": "MICHEAL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-25",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "113771",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "113771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN STATE LICENSE",
            "identifier": "113771",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Papillion, NE

Sources for this page

Verify at the official NPI Registry.