Organization Active NPI

Nebraska Orthopaedic Hospital LLC

  • Community/Retail Pharmacy
  • Elkhorn, NE
National Provider Identifier
1952271348
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
NEBRASKA ORTHOPAEDIC HOSPITAL LLC
Practice address
3415 S 205TH St RM B108
Elkhorn, NE 68022-3509
Phone
(402) 639-8415
NPI assigned
Nov 10, 2025
Organization subpart
Yes
Parent organization
NEBRASKA ORTHOPAEDIC HOSPITAL LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Authorized official

Name
Tara L Wisdom
Title
Crao
Phone
(402) 609-1002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

3415 S 205TH St RM B108
Elkhorn, NE 68022-3509

Mailing address

2808 S 143Rd PLZ
Omaha, NE 68144-5611
Phone (402) 609-3000

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
28D2329020Nebraska Orthopaedic Hospital3415 South 205TH Street, Room B100, Elkhorn, NE 68022Certificate of waiverAug 19, 2027

National Provider Directory

National Provider Directory
Tax ID family
Nebraska Orthopaedic LLC3 organizations share this tax ID, including this one
Part of
Nebraska Orthopaedic LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3415 S 205th St
Rm B108
Elkhorn, NE 68022
Phone (402) 639-8415

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1762732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762732800000",
    "number": "1952271348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 S 143RD PLZ",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681445611",
            "telephone_number": "402-609-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 S 205TH ST RM B108",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680223509",
            "telephone_number": "402-639-8415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEBRASKA ORTHOPAEDIC HOSPITAL LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEBRASKA ORTHOPAEDIC HOSPITAL LLC",
        "enumeration_date": "2025-11-10",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A",
        "authorized_official_last_name": "WISDOM",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CRAO",
        "authorized_official_telephone_number": "402-609-1002"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhorn, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.