Individual provider Active NPI

Keri Lazure, PA-C

  • Medical Physician Assistant
  • Bellevue, NE
National Provider Identifier
1902864622
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
894 Issued in NE
Practice address
2206 Longo Dr
Suite 201
Bellevue, NE 68005-2977
Phone
(402) 292-9170
Fax
(402) 292-0119
NPI assigned
May 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 894 NE Primary

Addresses

Primary practice location

2206 Longo Dr
Suite 201
Bellevue, NE 68005-2977

Mailing address

2206 Longo Dr Ste 201
Bellevue, NE 68005-2977
Phone (402) 292-9170

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
I20070216000041 NE Practitioner - Physician Assistant 4789786070 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellevue Family Practice PCGroup PAC ID 3476450032, 5 clinicians

Practice addresses (Care Compare)

2206 Longo Dr
Suite 201
Bellevue, NE 68005-2977
Phone (402) 292-0114

Hospital & facility affiliations

  • Hillcrest Home Care Home health agency, Bellevue, NE, CCN 287133
  • CHI Health Bergan Mercy Hospital, Omaha, NE, CCN 280060
  • CHI Health Midlands Hospital, Papillion, NE, CCN 280105
  • Bellevue Medical Center Hospital, Bellevue, NE, CCN 280132

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
894NEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Mar 18, 2018 Accepting new patients
Depot Drug Past Accepting new patients

Locations

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

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

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.

Hospital & facility affiliations 5

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1902864622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2206 LONGO DR STE 201",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680052977",
            "telephone_number": "402-292-9170",
            "fax_number": "402-292-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2206 LONGO DR",
            "address_2": "SUITE 201",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680052977",
            "telephone_number": "402-292-9170",
            "fax_number": "402-292-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZURE",
        "first_name": "KERI",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, NE

Sources for this page

Verify at the official NPI Registry.