Individual provider Active NPI

Nicole Marie Mixan, APRN

  • Family Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1841758372
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
112726 Issued in NE
Practice address
17810 Welch PLZ
Omaha, NE 68135-1620
Phone
(888) 333-7520
NPI assigned
Mar 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 112726 NE Primary

Addresses

Primary practice location

17810 Welch PLZ
Omaha, NE 68135-1620

Mailing address

7261 Mercy Rd
Omaha, NE 68124-2311

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
I20190404000355 NE Practitioner - Nurse Practitioner 4981945789 Reassigns benefits to 1 organization
I20210427000626 IA Practitioner - Nurse Practitioner 4981945789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, shared by 2 NPIs, 951 clinicians

Practice addresses (Care Compare)

1288 Valley View LN
Council Bluffs, IA 51503-5456
Phone (712) 328-8800

13315 W Ctr Rd
Omaha, NE 68137-3449
Phone (402) 717-9400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
112726NEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Apr 1, 2021 Accepting new patients
Alegent Creighton Clinic CurrentSince Mar 16, 2020 Accepting new patients

Locations

3135 W Broadway
Council Bluffs, IA 51501
Phone (712) 242-2040

3135 W Broadway
Ste 100
Council Bluffs, IA 51501
Phone (712) 242-2040

800 Mercy Dr
Ste 220
Council Bluffs, IA 51503
Phone (712) 388-2660

2771 Solution Ctr
Chicago, IL 60677

13315 W Center Rd
Omaha, NE 68144
Phone (402) 717-9400

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

3410 N 156th St
Omaha, NE 68116
Phone (402) 493-0390

5005 S 153rd St
Ste 100
Omaha, NE 68137
Phone (402) 614-1258

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1551657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1841758372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17810 WELCH PLZ",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681351620",
            "telephone_number": "888-333-7520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIXAN",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-04",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "112726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.