Individual provider Active NPI

Jean M Koliha, APRN

  • Pediatric Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1891850400
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
110338 Issued in NE
Practice address
Children'S Hospital - Endocrinology
8200 Dodge Street
Omaha, NE 68114-4113
Phone
(402) 955-3871
Fax
(402) 955-4184
NPI assigned
Dec 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 110338 NE Primary

Addresses

Primary practice location

Children'S Hospital - Endocrinology
8200 Dodge Street
Omaha, NE 68114-4113

Mailing address

Children'S Hospital
8200 Dodge Street
Omaha, NE 68114-4113
Phone (402) 955-5400

Other identifiers 3

IdentifierTypeStateIssuer
240727OtherMIDLANDS CHOICE
558262MedicaidIA
38729OtherNEBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141229001622 NE Practitioner - Nurse Practitioner 0042533911 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ear Nose & Throat - Head and Neck Surgery P.C. CurrentSince Aug 13, 2018 Accepting new patients

Locations

11704 W Center Rd
Ste 211
Omaha, NE 68144
Phone (402) 393-7050

555 Fortune Dr
Papillion, NE 68046
Phone (402) 397-7400

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": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891850400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CHILDREN'S HOSPITAL",
            "address_2": "8200 DODGE STREET",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144113",
            "telephone_number": "402-955-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CHILDREN'S HOSPITAL - ENDOCRINOLOGY",
            "address_2": "8200 DODGE STREET",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144113",
            "telephone_number": "402-955-3871",
            "fax_number": "402-955-4184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLIHA",
        "first_name": "JEAN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NE",
            "license": "110338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "240727",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "558262",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "38729",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.