NPIMap

Organization Active NPI

Children's Hospital & Medical Center

Doing business as Children's Nebraska Outpatient Surgery Center

  • Multi-Specialty Clinic/Center
  • Omaha, NE
National Provider Identifier
1962866418
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CHILDREN'S HOSPITAL & MEDICAL CENTER
Doing business as
Children's Hospital & Medical Center
Children's Nebraska Outpatient Surgery Center
Practice address
110 N 175TH St Ste 1600
Omaha, NE 68118-3581
Phone
(402) 955-5437
NPI assigned
Apr 11, 2016
Last updated
Oct 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Authorized official

Name
Chanda C Chacon
Title
President & Ceo
Phone
(402) 955-4106

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

110 N 175TH St Ste 1600
Omaha, NE 68118-3581

Mailing address

8200 Dodge St
Omaha, NE 68114-4113
Phone (402) 955-5400

Other names 2

  • Children's Hospital & Medical Center Doing business as
  • Children's Nebraska Outpatient Surgery Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040225000092 NE Part A Provider - Hospital 3173419355 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Omaha, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962866418. Details of each certification follow.

Hospital certification: CCN 283301

Legal name
CHILDRENS HOSPITAL & MEDICAL CENTER
Doing business as
CHILDREN'S NEBRASKA
Certification status
Active
Provider type (POS)
Hospital – Children’s
Participating since
Jan 1, 1984
Last certification
Nov 13, 1998
Beds
134
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Nov 30, 1943 in NE
Enrollment address
8200 Dodge St
Omaha, NE 68114-4113
Main/Primary Hospital Location
Hospital subgroups
Children’s, Other

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Children's NebraskaCCN 283301 · All quality measures
Type
Childrens
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

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
28D2202217Children's Nebraska Outpatient Surgery Center110 North 175TH Street Suite 1600, Omaha, NE 68118ComplianceOct 14, 2027

National Provider Directory

National Provider Directory
Tax ID family
Jon a Vanderhoof MD23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

1000 N 90th St
Ste 201
Omaha, NE 68114
Phone (402) 955-6190

10920 Q St
Omaha, NE 68137
Phone (402) 592-4726

17819 Pierce Plz
Omaha, NE 68130
Phone (402) 955-6102

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Chanda C Chacon Individual Corporate OfficerPresident & Ceo Sep 8, 2020
Corporate DirectorPresident & Ceo Sep 8, 2020
W-2 Managing EmployeePresident & Ceo Sep 8, 2020
Operational/Managerial ControlPresident & Ceo Sep 8, 2020
Nicole D Birge Individual Corporate Director Jan 1, 2024
Amy D Ryan Individual Corporate Officer Jan 1, 2022
Corporate Director Jan 1, 2017
Stephen P Lindsay Individual Corporate Director Jan 1, 2016
Amy L Hatcher Individual Corporate OfficerExecutive VP & Cfo Jul 16, 2021
W-2 Managing EmployeeExecutive VP & Cfo Jul 1, 2014
Operational/Managerial ControlExecutive VP & Cfo Jul 1, 2014
Herbert O Davies Individual Corporate Director Jan 1, 2023
Cindy M Heider Individual Corporate Director Jan 1, 2022
Stacy a Scholtz Individual Corporate Officer Jan 1, 2022
Corporate Director Jan 1, 2018
Farhan Khan Individual Corporate Director Jan 1, 2023
Katherine L English Individual Corporate OfficerExecutive VP & Coo Jul 16, 2021
W-2 Managing EmployeeExecutive VP & Coo Feb 1, 1993
Operational/Managerial ControlExecutive VP & Coo Feb 1, 1993
Robert W Dunlay Individual Corporate Director Jan 1, 2013
Samantha J Mosser Individual Corporate Officer Jan 1, 2019
Corporate Director Jan 1, 2016
David a Diamond Individual Corporate Director Jan 1, 2016
Bryan L Wilson Individual Corporate Director Jan 1, 2024
Jonathan Wegner Individual Corporate Director Jan 1, 2021
Margaret M Hershiser Individual Corporate Officer Jan 1, 2017
Corporate Director Jan 1, 2015

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 6

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696204800000",
    "number": "1962866418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 DODGE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144113",
            "telephone_number": "402-955-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N 175TH ST STE 1600",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681183581",
            "telephone_number": "402-955-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S HOSPITAL & MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-11",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A",
        "authorized_official_last_name": "CHACON",
        "authorized_official_first_name": "CHANDA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "402-955-4106"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Hospital & Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Children's Nebraska Outpatient Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.