Individual provider Active NPI

Kimberly L. Wordekemper, P.A.

  • Surgical Physician Assistant
  • Omaha, NE
National Provider Identifier
1962432245
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
1221 Issued in NE
Practice address
8303 Dodge St
Omaha, NE 68114-4108
Phone
(402) 354-4000
Fax
(402) 354-4290
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 1221 NE Primary

Addresses

Primary practice location

8303 Dodge St
Omaha, NE 68114-4108

Mailing address

PO Box 2797
Omaha, NE 68103-2797

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1221NEMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Orthopaedic Hospital LLC Past Accepting new patients
Pulmonary Medicine Institute PC PastSince Oct 1, 2005 Accepting new patients
Creighton University Past Accepting new patients
Omaha Center for Surgery, P.C. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kwordekemper21137@direct.nebraskamed.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1962432245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2797",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681032797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8303 DODGE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144108",
            "telephone_number": "402-354-4000",
            "fax_number": "402-354-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORDEKEMPER",
        "first_name": "KIMBERLY",
        "middle_name": "L.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NE",
            "license": "1221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; 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.