Omaha Tribe Of Nebraska | |
923 Senior Circle Macy NE 68039-4018 | |
(402) 837-5381 | |
(402) 837-5303 |
Full Name | Omaha Tribe Of Nebraska |
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Speciality | Clinic/Center |
Location | 923 Senior Circle, Macy, Nebraska |
Authorized Official Name and Position | Sarah Rowland (CEO) |
Authorized Official Contact | 4028375381 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Omaha Tribe Of Nebraska Po Box 250 Macy NE 68039-0250 Ph: (402) 837-5381 | Omaha Tribe Of Nebraska 923 Senior Circle Macy NE 68039-4018 Ph: (402) 837-5381 |
NPI Number | 1871977918 |
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Provider Enumeration Date | 07/18/2015 |
Last Update Date | 01/07/2025 |
Medicare PECOS PAC ID | 7315467560 |
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Medicare Enrollment ID | O20250219000691 |
Identifier | Type | State | Issuer |
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1871977918 | NPI | - | NPPES |
100261088-00 | Medicaid | NE |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Provider Name | Marissa Lundeen |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356113625 PECOS PAC ID: 1951744234 Enrollment ID: I20240425000572 |
Provider Name | Trisha M Harms |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164078333 PECOS PAC ID: 5890024053 Enrollment ID: I20250228000501 |
Provider Name | Amanda L Larson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457745986 PECOS PAC ID: 2961720982 Enrollment ID: I20250228000719 |
Provider Name | Misty D Carlson |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1083662324 PECOS PAC ID: 5597031294 Enrollment ID: I20250307000127 |
Provider Name | Timothy J Ernesti |
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Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1972827194 PECOS PAC ID: 3870969645 Enrollment ID: I20250313001696 |