Stephanie R Revord (NPI# 1174992846, PAC ID# 3274833538) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1174992846 |
| PAC ID by PECOS | 3274833538 |
| Professional Enrollment ID | I20151118002775 |
| Full Name | Stephanie R Revord |
| Organization Legal Name | PHYSICIANS CLINIC INC |
| Address |
3353 L St Omaha NE 68107-2500 |
| Phone Number | 4023547700 |
| Gender | F |
| Medical School | UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE |
| Graduation Year | 2015 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 4880506062 |
| Number of Group Practice Members | 376 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 160047 | METHODIST JENNIE EDMUNDSON |
| Address | Phone | Organization |
|---|---|---|
| 201 Ridge St, Suite 312, Council Bluffs, IA 51503-4643 | 7123967880 | PHYSICIANS CLINIC INC |
| 3353 L St, Omaha, NE 68107-2500 | 4023547700 | PHYSICIANS CLINIC INC |
| Organization Legal Name | PHYSICIANS CLINIC INC |
| Physicians | 386 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael Klug | Internal Medicine | Physicians Clinic Inc | 16120 W Dodge Rd, Omaha, NE 68118-2049 |
| Jami Jo Dowell | Nurse Practitioner | Physicians Clinic Inc | 1400 Senate Ave, 105 Methodist Physicians Clinic Red Oak, Red Oak, IA 51566-1271 |
| Stephen Tetrault | Family Medicine | Physicians Clinic Inc | 17675 Welch Plz, Omaha, NE 68135-3453 |
| Maureen A Boyle-manganaro | Obstetrics/gynecology | Physicians Clinic Inc | 320 Ebaugh St, Methodist Physicians Clinic Glenwood, Glenwood, IA 51534-1811 |
| Umasankari Sundaram | Endocrinology | Physicians Clinic Inc | 7831 Chicago Ct, Omaha, NE 68114-3654 |
| Karen T Bagniewski | Nurse Practitioner | Physicians Clinic Inc | 10710 Fort St, Omaha, NE 68134-1204 |
| Angela R Vogel | Nurse Practitioner | Physicians Clinic Inc | 933 E Pierce St, Methodist Jennie Edmundson, Council Bluffs, IA 51503-4626 |
| Jennifer D Stone | Family Medicine | Physicians Clinic Inc | 1001 Risen Son Blvd, Council Bluffs, IA 51503-1910 |
| Anand R Deshmukh | Cardiovascular Disease (cardiology) | Physicians Clinic Inc | 1120 N 103rd Plaza, Omaha, NE 68114-1119 |
| Claudia M Balta | Physician Assistant | Physicians Clinic Inc | 1 Edmundson Pl, 310 Methodist Physicians Clinic Council Bluffs, Council Bluffs, IA 51503-4658 |
| Street Address |
3353 L ST |
| City | OMAHA |
| State | NE |
| Zip | 68107-2500 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Erik N Schulte | Obstetrics/gynecology | Physicians Clinic Inc | 3353 L St, Omaha, NE 68107-2500 |
| Rebecca A Leaders | Nurse Practitioner | Physicians Clinic Inc | 3353 L St, Omaha, NE 68107-2500 |
| Desiree M Hericks | Certified Nurse Midwife (cnm) | Physicians Clinic Inc | 3353 L St, Omaha, NE 68107-2500 |
| David W Stamm | Family Medicine | Physicians Clinic Inc | 3353 L St, Omaha, NE 68107-2500 |
| Timothy L Buresh | Physical Therapy | Physicians Clinic Inc | 3353 L St, Omaha, NE 68107-2500 |
| Margarita Dickey | Pediatric Medicine | Physicians Clinic Inc | 3353 L St, Omaha, NE 68107-2500 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daniel Pearson | Family Medicine | Alegent Creighton Clinic | 4220 L St, Suite 100, Omaha, NE 68107-1048 |
| Emily Claire States | Physician Assistant | Alegent Creighton Clinic | 4220 L St, Suite 100, Omaha, NE 68107-1048 |
| Margaret Leigh Wallace | Nurse Practitioner | Alegent Creighton Clinic | 4220 L St, Suite 100, Omaha, NE 68107-1048 |
| Yulia Reyes | Nurse Practitioner | Alegent Creighton Clinic | 4220 L St, Suite 100, Omaha, NE 68107-1048 |
| Kristi E Newmyer | Obstetrics/gynecology | Alegent Creighton Clinic | 4220 L St, Suite 100, Omaha, NE 68107-1048 |
| Ronette L Lammers | Nurse Practitioner | Alegent Creighton Clinic | 4220 L St, Suite 100, Omaha, NE 68107-1048 |
| Amanda Anson | Physician Assistant | Alegent Creighton Clinic | 4220 L St, Suite 100, Omaha, NE 68107-1048 |
| Wolfgang Fabio Rodriguez | Family Medicine | Alegent Creighton Clinic | 4220 L St, Suite 100, Omaha, NE 68107-1048 |
| Kirtibala Gupta | Internal Medicine | Alegent Creighton Clinic | 4220 L St, Suite 100, Omaha, NE 68107-1048 |
| Andrea M Herman | Family Medicine | Alegent Creighton Clinic | 4220 L St, Suite 100, Omaha, NE 68107-1048 |
| Find all physicians in zip 68107 | |||
| City | OMAHA |
| Zip Code | 68107 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | OMAHA + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.