Individual provider Active NPI

Cheryl L Calabro, APRN-NP

  • Pediatric Nurse Practitioner
  • Council Bluffs, IA
National Provider Identifier
1851767412
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
111865 Issued in NE
Practice address
1022 Woodbury Ave
Council Bluffs, IA 51503-7915
Phone
(712) 352-0405
NPI assigned
Aug 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 111865 NE Primary

Addresses

Primary practice location

1022 Woodbury Ave
Council Bluffs, IA 51503-7915

Mailing address

1022 Woodbury Ave
Council Bluffs, IA 51503-7915

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
I20181101000744 NE Practitioner - Nurse Practitioner 7911250386 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
111865NEMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Father Flanagan'S Boys' Home Pediatrics CurrentSince Oct 8, 2018 Accepting new patients
ENT Services PC Past Accepting new patients
Nebraska Pediatric Practice, Inc Past Accepting new patients

Locations

14080 Boys Town Hospital Rd
Boys Town, NE 68010
Phone (402) 778-6900

1540 N 72nd St
Omaha, NE 68114
Phone (402) 393-8693

8200 Dodge St
Omaha, NE 68114
Phone (402) 955-4350

Organizations & group practices 3

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": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439856000000",
    "number": "1851767412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 WOODBURY AVE",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515037915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 WOODBURY AVE",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515037915",
            "telephone_number": "712-352-0405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALABRO",
        "first_name": "CHERYL",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "APRN-NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-18",
        "last_updated": "2015-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NE",
            "license": "111865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

Verify at the official NPI Registry.