Individual provider Active NPI

Arlana R Phillips, MD

  • Pediatric Adolescent Medicine Physician
  • Omaha, NE
National Provider Identifier
1952418022
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
27702 Issued in NE
Practice address
2915 Grant Street
Omaha, NE 68103
Phone
(402) 457-1200
Fax
(402) 453-1970
NPI assigned
Aug 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 27702 NE Primary

Addresses

Primary practice location

2915 Grant Street
Omaha, NE 68103

Mailing address

PO Box 30019
2915 Grant Street
Omaha, NE 68103
Phone (402) 457-1200

Other identifiers 1

IdentifierTypeStateIssuer
47066671500MedicaidNE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040604000834 NE Practitioner - Pediatric Medicine 1456333178 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
27702NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charles Drew Health Center, Inc CurrentSince Jul 18, 2011 Accepting new patients
Charles Drew Health Center, Inc. CurrentSince Jul 18, 2011 Accepting new patients
Charles Drew Health Center Inc PastSince May 25, 2021 Accepting new patients

Locations

2915 Grant St
Omaha, NE 68111
Phone (402) 451-3553

Interoperability endpoints

  • Direct secure messaging: arlana.phillips.p1@direct.charlesdrew.nextgenshare.com

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353974400000",
    "number": "1952418022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30019",
            "address_2": "2915 GRANT STREET",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68103",
            "telephone_number": "402-457-1200",
            "fax_number": "402-453-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 GRANT STREET",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68103",
            "telephone_number": "402-457-1200",
            "fax_number": "402-453-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "ARLANA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2012-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NE",
            "license": "27702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47066671500",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.