| Omaha Tribe Of Nebraska | |
|
923 Senior Circle Macy NE 68039-4018 | |
| (402) 837-5381 | |
| (402) 837-5303 |
| Full Name | Omaha Tribe Of Nebraska |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 07/18/2015 |
| Last Update Date | 01/07/2025 |
| Medicare PECOS PAC ID | 7315467560 |
|---|---|
| Medicare Enrollment ID | O20250219000691 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871977918 | NPI | - | NPPES |
| 100261088-00 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Kham V Ung |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1205937554 PECOS PAC ID: 5193708451 Enrollment ID: I20040609000584 |
| Provider Name | Arvin Lopez Santos |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336363324 PECOS PAC ID: 5395896328 Enrollment ID: I20150707000323 |
| Provider Name | Teresa Claire Evan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124422597 PECOS PAC ID: 2860719804 Enrollment ID: I20240411003138 |
| Provider Name | Marissa Lundeen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356113625 PECOS PAC ID: 1951744234 Enrollment ID: I20240425000572 |
| Provider Name | Trisha M Harms |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164078333 PECOS PAC ID: 5890024053 Enrollment ID: I20250228000501 |
| Provider Name | Amanda L Larson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457745986 PECOS PAC ID: 2961720982 Enrollment ID: I20250228000719 |
| Provider Name | Misty D Carlson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083662324 PECOS PAC ID: 5597031294 Enrollment ID: I20250307000127 |
| Provider Name | Timothy J Ernesti |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1972827194 PECOS PAC ID: 3870969645 Enrollment ID: I20250313001696 |
| Provider Name | Ashleen L Blackbird |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497356125 PECOS PAC ID: 8921410812 Enrollment ID: I20250319000396 |
| Provider Name | Linda L Kneebone |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1003027384 PECOS PAC ID: 6800964461 Enrollment ID: I20250328000228 |
| Provider Name | Stephanie Conway |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497486906 PECOS PAC ID: 6305369588 Enrollment ID: I20250328000321 |
| Provider Name | Dwight D Encinas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942378757 PECOS PAC ID: 9436160140 Enrollment ID: I20250328001018 |
| Provider Name | Sally Choat |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1851673362 PECOS PAC ID: 7416470513 Enrollment ID: I20250331000383 |
| Provider Name | Faith M Jenkins |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1073932745 PECOS PAC ID: 3971036336 Enrollment ID: I20250331000843 |
| Provider Name | Scott A Varilek |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1992101851 PECOS PAC ID: 8820308984 Enrollment ID: I20250402002731 |
| Provider Name | Jane C Maddox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982613188 PECOS PAC ID: 3678667920 Enrollment ID: I20250403000153 |
| Provider Name | Juan P Munoz |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1033507207 PECOS PAC ID: 3476878075 Enrollment ID: I20250403001654 |
| Provider Name | Tammie A Jensen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548490089 PECOS PAC ID: 8123551652 Enrollment ID: I20250407000757 |
| Provider Name | Steven A Westby |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023106150 PECOS PAC ID: 6204842917 Enrollment ID: I20250408000598 |
| Provider Name | Rodney J Dean |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528037082 PECOS PAC ID: 3870585813 Enrollment ID: I20250408002264 |
| Provider Name | Mallory Drenth |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1346849544 PECOS PAC ID: 6305360157 Enrollment ID: I20250414001903 |
| Provider Name | Cassidy Simons |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1144959644 PECOS PAC ID: 4789060070 Enrollment ID: I20250425001408 |
| Provider Name | Brandon M Ridder |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1851731459 PECOS PAC ID: 9032352257 Enrollment ID: I20250429000043 |
| Provider Name | Gwendolyn M Porter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326594136 PECOS PAC ID: 4880111756 Enrollment ID: I20250505003314 |
| Provider Name | Jacob R Kringle |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1205366879 PECOS PAC ID: 6103197827 Enrollment ID: I20250507002531 |
| Provider Name | Patrick K Chau |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992766299 PECOS PAC ID: 0648283432 Enrollment ID: I20250613001128 |