Healthcare Provider Details

I. General information

NPI: 1265498661
Provider Name (Legal Business Name): EMERGENCY CLINICIANS ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 09/09/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6901 N 72ND ST
OMAHA NE
68122-1709
US

IV. Provider business mailing address

PO BOX 31058
OMAHA NE
68131-0058
US

V. Phone/Fax

Practice location:
  • Phone: 402-572-2225
  • Fax:
Mailing address:
  • Phone: 866-898-7142
  • Fax: 616-975-9824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. CHADD SHUFF
Title or Position: GROUP HEAD/PHYSICIAN
Credential: MD
Phone: 402-680-7348