ALEGENT HEALTH IMMANUEL MEDICAL CENTER (NPI# 1326126509) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326126509 |
| Entity Type | Organization |
| Organization Name | ALEGENT HEALTH IMMANUEL MEDICAL CENTER |
| Other Organization Name | CHI HEALTH IMMANUEL |
| Practice Address |
6901 N 72nd St Omaha NE 68122-1709 |
| Practice Telephone | 4025722291 |
| Practice Fax Number | 4025723177 |
| Mailing Telephone | 4025722291 |
| Mailing Fax Number | 4025723177 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2019-10-10 |
| Authorized Official Name | CLIFF A ROBERTSON (CEO - CHI HEALTH) |
| Authorized Official Telephone | 4023434420 |
| Is Organization Subpart | Y |
| Parent Organization Name | ALEGENT HEALTH IMMANUEL MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | 260002 | NE | Hospital Units |
| Other Name | Type Code |
|---|---|
| CHI Health Heritage Center | Doing Business As Name - Organization |
| CHI HEALTH IMMANUEL | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992964100 | Alegent Health Immanuel Medical Center | Psychiatric Residential Treatment Facility | 6845 N 68th Plaza, Omaha, NE 68122 | 2008-06-03 |
| 1154406643 | Alegent Health Immanuel Medical Center | Skilled Nursing Facility | 6809 N 68th Plz, Omaha, NE 68152-2117 | 2006-10-25 |
| 1306137260 | Alegent Health Immanuel Medical Center | Durable Medical Equipment & Medical Supplies | 6901 N 72nd St, Suite 2200, Omaha, NE 68122-1709 | 2011-04-27 |
| 1801129838 | Alegent Health Immanuel Medical Center | Durable Medical Equipment & Medical Supplies | 6901 N 72nd St, Omaha, NE 68122-1709 | 2009-09-09 |
| 1427283795 | Alegent Health Immanuel Medical Center | Psychiatric Unit | 6901 N 72nd St, Omaha, NE 68122-1709 | 2009-05-15 |
| 1912192907 | Alegent Health Immanuel Medical Center | Radiology | 6901 N 72nd St, Omaha, NE 68122-1709 | 2007-09-12 |
| 1497891543 | Alegent Health Immanuel Medical Center | Clinical Neuropsychologist | 6901 N 72nd St, Omaha, NE 68122-1709 | 2007-01-29 |
| 1912085184 | Alegent Health Immanuel Medical Center | Clinic/Center | 6901 N 72nd St, Omaha, NE 68122-1709 | 2006-11-02 |
| 1669550844 | Alegent Health Immanuel Medical Center | Durable Medical Equipment & Medical Supplies | 6901 N 72nd St, Attn Administrator, Omaha, NE 68122-1709 | 2006-11-02 |
| 1760567010 | Alegent Health Immanuel Medical Center | Neurological Surgery | 6901 N 72nd St, Omaha, NE 68122-1709 | 2006-10-26 |
| Street Address |
6901 N 72ND ST |
| City | OMAHA |
| State | NE |
| Zip Code | 68122-1709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386641686 | Paul L. Price | Pharmacist | 6901 N 72nd St, Omaha, NE 68122-1709 | 2005-06-30 |
| 1205436896 | Jennifer S Bostick | Counselor | 6901 N 72nd St, Omaha, NE 68122-1709 | 2020-11-01 |
| 1861028847 | Ryan Pirraglia | Nurse Practitioner | 6901 N 72nd St, Omaha, NE 68122-1709 | 2020-03-21 |
| 1417507260 | Stacey M Samuel | Physician Assistant | 6901 N 72nd St, Omaha, NE 68122-1709 | 2019-09-13 |
| 1861041238 | Jonathan Robbins | Nurse Practitioner | 6901 N 72nd St, Omaha, NE 68122-1709 | 2019-09-09 |
| 1114408531 | Nicole M Anthony | Nurse Practitioner | 6901 N 72nd St, Omaha, NE 68122-1709 | 2018-08-23 |
| 1144746322 | Nicole M Privitera | Nurse Practitioner | 6901 N 72nd St, Omaha, NE 68122-1709 | 2017-08-18 |
| 1588196299 | Felina Brown | Nurse Practitioner | 6901 N 72nd St, Attn: Hospital Medicine Dept., Omaha, NE 68122-1709 | 2017-03-31 |
| 1851846380 | Jacqueline Jaramillo | Nurse Practitioner | 6901 N 72nd St, Omaha, NE 68122-1709 | 2016-08-25 |
| 1942755954 | Date Amouzou | Nurse Practitioner | 6901 N 72nd St, Omaha, NE 68122-1709 | 2016-08-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609282920 | Andre Jordan | Registered Nurse | 7215 N. 90th Street, Omaha, NE 68122 | 2014-07-08 |
| 1063748895 | Amy Kristine Jones | Speech-Language Pathologist | 703 Country View Dr, Champaign, IL 68122 | 2009-10-29 |
| 1992964100 | Alegent Health Immanuel Medical Center | Psychiatric Residential Treatment Facility | 6845 N 68th Plaza, Omaha, NE 68122 | 2008-06-03 |
| 1093835852 | Suzane Lynne Bohlen | Nurse Anesthetist, Certified Registered | 6901 N 72 St, Omaha, NE 68122 | 2007-03-29 |
| 1376686733 | Midwest Surgical Associates PC | Surgery | 6828 N 72 St, #5500, Omaha, NE 68122 | 2007-02-15 |
| 1902975386 | Midwest Medical Imaging Center Inc | Radiology | Midwest Medical Imaging Center, 6901 North 72nd Street, Omaha, NE 68122 | 2006-11-07 |
| 1245348754 | Scott Denman Wilt | Anesthesiology | 6901 N 72 Street, Omaha, NE 68122 | 2006-08-25 |
| 1982620639 | Robert J Zadalis | Surgery | 6829 N 72nd St Ste 5500, Omaha, NE 68122 | 2006-07-14 |
| 1245299304 | Kristin Nicole Krobot | Physician Assistant | 6901 N. 72nd St., Immanuel Emergency Room, Omaha, NE 68122 | 2006-03-18 |
| 1326575440 | Kathleen L Koeppel | Registered Nurse | 6901 N 72nd Street, Attn: Diabetic Education, Omaha, NE 68122 | 2017-05-19 |
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| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396969499 | Alegent Health Bergan Mercy Health System | Psychiatric Unit | 415 S 25th Ave, Omaha, NE 68131-3654 | 2007-04-12 |
| 1386712925 | Nebraska Medical Center | Psychiatric Unit | 987400 Nebraska Medical Ctr Fl 7, 7th Floor Uh (7psy), Omaha, NE 68198-7400 | 2006-12-01 |
| 1427283795 | Alegent Health Immanuel Medical Center | Psychiatric Unit | 6901 N 72nd St, Omaha, NE 68122-1709 | 2009-05-15 |
| 1518091230 | Children's Hospital | Psychiatric Unit | 8200 Dodge St, Children's Hospital - Eating Disorders Program, Omaha, NE 68114-4113 | 2007-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073599189 | Crane River Clinic | Psychiatric Unit | 3280 Woodridge Blvd, Suite 260, Grand Island, NE 68801-7481 | 2005-12-20 |
| 1144709122 | Methodist Fremont Health | Psychiatric Unit | 450 E 23rd St, Fremont, NE 68025-2387 | 2018-08-09 |
| 1720441074 | Fremont Health | Psychiatric Unit | 450 E 23rd St, Fremont, NE 68025-2387 | 2016-04-04 |
| 1457745119 | Fillmore County Hospital | Psychiatric Unit | 1900 F St, Geneva, NE 68361-2229 | 2015-03-20 |
| 1134216773 | Bryan Medical Center | Psychiatric Unit | 2300 S 16th St, Lincoln, NE 68502-3780 | 2006-10-06 |
| 1568570745 | The Mary Lanning Memorial Hospital Association | Psychiatric Unit | 715 N Saint Joseph Ave, Hastings, NE 68901-4497 | 2006-08-28 |
| 1871606137 | Regional West Medical Center | Psychiatric Unit | 4021 Avenue B, Scottsbluff, NE 69361-4602 | 2006-08-17 |
| 1114942869 | Good Samaritan Hospital | Psychiatric Unit | 1755 Prairie View Pl, Kearney, NE 68845-8300 | 2006-07-13 |
| 1336184019 | Good Samaritan Hospital | Psychiatric Unit | 10 E 31st St, Box 1990, Kearney, NE 68847-2926 | 2006-06-18 |
| 1285676544 | Faith Regional Health Services | Psychiatric Unit | 2700 W Norfolk Ave, Norfolk, NE 68701-4438 | 2006-06-12 |
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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.