Individual provider Active NPI

Clancy Ellen McNally, M.D.

  • Pediatrics Physician
  • Bellevue, NE
National Provider Identifier
1902926223
Registry record updated Aug 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
24571 Issued in NE
Practice address
11507 S 42ND St
Bellevue, NE 68123-6006
Phone
(402) 955-7600
Fax
(402) 955-7601
NPI assigned
Mar 30, 2007
Last updated
Aug 27, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 24571 NE Primary

Addresses

Primary practice location

11507 S 42ND St
Bellevue, NE 68123-6006

Mailing address

11507 S 42ND St
Bellevue, NE 68123-6006
Phone (402) 955-7600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
24571NEMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Nebraska Board of Regents Past Accepting new patients
Alegent Health Bergan Mercy Health System Past Accepting new patients
Children's Physicians Pediatrics Past Accepting new patients

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346025600000",
    "number": "1902926223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11507 S 42ND ST",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "681236006",
            "telephone_number": "402-955-7600",
            "fax_number": "402-955-7601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11507 S 42ND ST",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "681236006",
            "telephone_number": "402-955-7600",
            "fax_number": "402-955-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNALLY",
        "first_name": "CLANCY",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2012-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "24571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.