Individual provider Active NPI

Aimy Irenaeia Mahony, APRN-FNP-C

  • Family Medicine Physician
  • Chadron, NE
National Provider Identifier
1992217988
Registry record updated Oct 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2021 Issued in NE
Practice address
825 Centennial Dr
Chadron, NE 69337-9400
Phone
(308) 432-5586
NPI assigned
Oct 30, 2017
Last updated
Oct 30, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2021 NE Primary

Addresses

Primary practice location

825 Centennial Dr
Chadron, NE 69337-9400

Mailing address

825 Centennial Dr
Chadron, NE 69337-9400
Phone (402) 677-1006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190319000923 TX Practitioner - Nurse Practitioner 5193081883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wagner Indian Health Service Health CenterGroup PAC ID 6305758483, 15 clinicians

Practice addresses (Care Compare)

111 Washington Ave NW
Wagner, SD 57380-4300
Phone (605) 384-4820

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2021NEMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wagner Indian Health Service Health Center CurrentSince Jan 14, 2019 Accepting new patients
Chadron Medical Clinic PC Family Medicine Past Accepting new patients

Locations

111 Washington Ave NW
Wagner, SD 57380
Phone (605) 384-3621

Organizations & group practices 2

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": "1509321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509321600000",
    "number": "1992217988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 CENTENNIAL DR",
            "city": "CHADRON",
            "state": "NE",
            "postal_code": "693379400",
            "telephone_number": "402-677-1006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 CENTENNIAL DR",
            "city": "CHADRON",
            "state": "NE",
            "postal_code": "693379400",
            "telephone_number": "308-432-5586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHONY",
        "first_name": "AIMY",
        "middle_name": "IRENAEIA",
        "credential": "APRN-FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-30",
        "last_updated": "2017-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "2021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chadron, NE

Sources for this page

Verify at the official NPI Registry.