BRONWYN LARISSA SMALL (NPI# 1295175016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295175016 |
| Entity Type | Individual |
| Full Name | BRONWYN LARISSA SMALL |
| Credential | M.D. |
| Practice Address |
4014 Leavenworth St Omaha NE 68105-1053 |
| Mailing Address |
988102 Nebraska Medical Ctr Omaha NE 68198-8102 |
| Practice Telephone | 4025595208 |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2019-08-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
31614 | NE | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | OHIO LICENSE | 128867 | 01 |
| Street Address |
4014 LEAVENWORTH ST |
| City | OMAHA |
| State | NE |
| Zip Code | 68105-1053 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316995665 | Edward Vincent Fehringer | Orthopaedic Surgery | 4014 Leavenworth St, Omaha, NE 68105-1053 | 2006-05-05 |
| 1518582261 | Laura A Cox | Physician Assistant | 4014 Leavenworth St, Omaha, NE 68105-1053 | 2020-06-09 |
| 1235794702 | Nicole K Bowdino | Otolaryngology | 4014 Leavenworth St, Omaha, NE 68105-1053 | 2019-05-09 |
| 1639654759 | Mikaela A Bounds | Physician Assistant | 4014 Leavenworth St, Omaha, NE 68105-1053 | 2018-09-25 |
| 1467948646 | Jennifer Ann Zielinski | Nurse Practitioner | 4014 Leavenworth St, Omaha, NE 68105-1053 | 2018-07-10 |
| 1407347784 | Margaret Baumann | Nurse Practitioner | 4014 Leavenworth St, Omaha, NE 68105-1053 | 2018-05-23 |
| 1457868358 | Elizabeth A Hegge | Nurse Practitioner | 4014 Leavenworth St, Omaha, NE 68105-1053 | 2018-01-02 |
| 1073031233 | Mary Louise Jorgenson | Physician Assistant | 4014 Leavenworth St, Omaha, NE 68105-1053 | 2017-09-07 |
| 1609302025 | Emily Bosen | Audiologist | 4014 Leavenworth St, Omaha, NE 68105-0006 | 2017-05-04 |
| 1427597053 | Nicole Koricic | Nurse Practitioner | 4014 Leavenworth St, Omaha, NE 68105-1053 | 2017-02-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679018030 | Buoyant Family Services Counseling and Consulting LLC | Community/Behavioral Health | The Center 1941 South 42nd Street, Suite 416 S, Omaha, NE 68105 | 2016-12-21 |
| 1497104442 | Michael Lee Powell | Family Medicine | 4305 Dewey Ave, Omaha, NE 68105 | 2016-06-10 |
| 1164896361 | Kyla Haner | Counselor | 1941 S. 42nd St. Ste 514, Omaha, NE 68105 | 2015-11-25 |
| 1114359189 | Kayli Ann Bendlin | Pharmacist | 4101 Woolworth Ave.-mailstop 119, Va Medical Center-pharmacy Department, Omaha, NE 68105 | 2013-08-01 |
| 1740622372 | Ashley M Ortiz | Nurse Practitioner | 4350 Dewey Avenue, Omaha, NE 68105 | 2013-07-24 |
| 1043519655 | Mandy J Hansen | Counselor | 2101 S. 42nd Street, Omaha, NE 68105 | 2011-03-22 |
| 1851537302 | Magda Maria Blanco | Counselor | 1941 South 42nd St Suite 541, Suite 541, Omaha, NE 68105 | 2009-01-05 |
| 1609050848 | James Joseph Shehan | Internal Medicine | 4100 Woolworth, Omaha, NE 68105 | 2007-12-24 |
| 1407051477 | Cristian D Clark | Counselor | 2101 S 42nd Street, Heartland Family Service, Omaha, NE 68105 | 2007-06-19 |
| 1831312305 | Kelli Renae Welvaert | Counselor | 2101 So 42 St, Heartland Family Service, Omaha, NE 68105 | 2007-04-11 |
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| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144663204 | Keenan W Taylor | Internal Medicine | 982465 Nebraska Medicine, Omaha, NE 68198-1938 | 2013-04-09 |
| 1013223783 | Nebraska Pulmonary Medicine PC | Internal Medicine | 4242 Farnam St Ste 150, Omaha, NE 68131-2808 | 2010-08-19 |
| 1033226477 | Mp-cc PC | Internal Medicine | 8552 Cass Str, Suite 301, Omaha, NE 68114 | 2006-08-23 |
| 1689654303 | Bryan J Krajicek | Internal Medicine | 7710 Mercy Rd # 3000, Omaha, NE 68124-2372 | 2006-01-19 |
| 1811999873 | George Thommi | Internal Medicine | 8552 Cass St, Suite 301, Omaha, NE 68114-3570 | 2005-06-02 |
| 1902800287 | John C. Shehan | Internal Medicine | 1120 N 103rd Plz Ste 102, Omaha, NE 68114-1119 | 2005-06-02 |
| 1891180980 | Michael John Kaster | Internal Medicine | 7500 Mercy Rd, Omaha, NE 68124-2319 | 2015-04-06 |
| 1730595158 | Jeffrey Macaraeg | Internal Medicine | 7710 Mercy Rd Ste 3000, Omaha, NE 68124-2350 | 2014-07-07 |
| 1770997462 | Craig Cookman | Internal Medicine | 7710 Mercy Rd Ste 3000, Omaha, NE 68124-2350 | 2014-06-20 |
| 1467890889 | Afoma Jane King | Internal Medicine | 7710 Mercy Rd, Omaha, NE 68124-2372 | 2013-06-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.