=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609765296
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ONEHEALTH NEBRASKA ACO LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/30/2025
-----------------------------------------------------
Last Update Date | 06/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4600 VALLEY ROAD SUITE 400
-----------------------------------------------------
City | LINCOLN
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68510-4856
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-261-9530
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4600 VALLEY ROAD SUITE 400
-----------------------------------------------------
City | LINCOLN
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68510-4856
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-261-9530
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | RHIANNON MARSHALL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 402-261-9530
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 305R00000X
-----------------------------------------------------
Taxonomy Name | Preferred Provider Organization
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------