MR. KOSSI MAWOULI ZOTOGLO (NPI# 1891202131) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891202131 |
| Entity Type | Individual |
| Full Name | MR. KOSSI MAWOULI ZOTOGLO |
| Credential | PA-C |
| Practice Address |
4101 Woolworth Ave Omaha NE 68105-1850 |
| Mailing Address |
3254 S 72nd Ave Omaha NE 68124-3576 |
| Practice Telephone | 4029953462 |
| Mailing Telephone | 4026811036 |
| Enumeration Date | 2018-01-09 |
| Last Update Date | 2018-02-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
090410 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4101 WOOLWORTH AVE |
| City | OMAHA |
| State | NE |
| Zip Code | 68105-1850 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598759870 | Allan Hancock | Dentist | 4101 Woolworth Ave, Dental Department 160, Omaha, NE 68105-1850 | 2005-09-01 |
| 1164034849 | Richard Dunn | Pharmacy Technician | 4101 Woolworth Ave, Omaha, NE 68105-1850 | 2020-08-23 |
| 1558979575 | Kristianna L Farley | Nurse Practitioner | 4101 Woolworth Ave, Omaha, NE 68105-1850 | 2020-07-15 |
| 1427671080 | Kelly Lea Baxter | Pharmacist | 4101 Woolworth Ave, Omaha, NE 68105-1850 | 2020-05-18 |
| 1255954806 | Ashleigh Grammar | Pharmacist | 4101 Woolworth Ave, Omaha, NE 68105-1850 | 2020-05-18 |
| 1437784170 | Chad Michael Conrad | Respiratory Therapist, Registered | 4101 Woolworth Ave, Omaha, NE 68105-1850 | 2020-03-03 |
| 1437783669 | Jordan Lynn Ruskamp | Registered Nurse | 4101 Woolworth Ave, Omaha, NE 68105-1850 | 2020-02-26 |
| 1467009902 | Michelle Marie Inzauro | Registered Nurse | 4101 Woolworth Ave, Omaha, NE 68105-1850 | 2019-08-20 |
| 1720633092 | Jacob Leons | Audiologist | 4101 Woolworth Ave, Omaha, NE 68105-1850 | 2019-08-05 |
| 1477118230 | Topacio Anahi Ortiz | Dietitian, Registered | 4101 Woolworth Ave, Omaha, NE 68105-1850 | 2019-05-07 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 68105 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518031194 | Peter W Hunt | Physician Assistant | Children's Hospital - Cardiothoracic Surgery, 8200 Dodge Street, Omaha, NE 68114-4113 | 2006-11-17 |
| 1457354789 | Jennifer Chavez | Physician Assistant | 9850 Nicholas St, Ste 250, Omaha, NE 68114-2186 | 2005-05-31 |
| 1184224537 | Ashton N Groves | Physician Assistant | 8200 Dodge St, Omaha, NE 68114-4113 | 2020-10-27 |
| 1336763879 | Makenzie Polacek | Physician Assistant | 13616 California St Ste 100, Omaha, NE 68154-5336 | 2020-06-01 |
| 1508499054 | Samantha Schroeder | Physician Assistant | 13616 California St Ste 100, Omaha, NE 68154-5336 | 2020-02-12 |
| 1487121034 | Kelli D Welch | Physician Assistant | 8200 Dodge St, Omaha, NE 68114-4113 | 2018-10-31 |
| 1114405040 | Victoria M Alai | Physician Assistant | 8200 Dodge St, Omaha, NE 68114-4113 | 2018-08-02 |
| 1710426549 | Jessica Cannon | Physician Assistant | 17030 Lakeside Hills Plz, Suite 200, Omaha, NE 68130-2396 | 2017-02-13 |
| 1952649162 | Samantha J. Korth | Physician Assistant | 16909 Lakeside Hills Ct, #208, Omaha, NE 68130-4664 | 2013-01-22 |
| 1801150511 | Anthony Robert Mann | Physician Assistant | 16909 Lakeside Hills Ct, Suite 208, Omaha, NE 68130-4664 | 2012-06-27 |
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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.