Healthcare Provider Details

I. General information

NPI: 1205163623
Provider Name (Legal Business Name): NPPI - ANESTHESIOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2009
Last Update Date: 01/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 DODGE STREET
OMAHA NE
68114-4113
US

IV. Provider business mailing address

PO BOX 30265
OMAHA NE
68103-1365
US

V. Phone/Fax

Practice location:
  • Phone: 402-955-4303
  • Fax: 402-955-4300
Mailing address:
  • Phone: 800-411-7538
  • Fax: 817-334-0235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number
License Number StateNE

VIII. Authorized Official

Name: KELLY S WEILER
Title or Position: DIRECTOR MANAGED CARE
Credential: JD
Phone: 402-955-6826