Provider Demographics
NPI:1205163623
Name:NPPI - ANESTHESIOLOGY
Entity type:Organization
Organization Name:NPPI - ANESTHESIOLOGY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR MANAGED CARE
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:S
Authorized Official - Last Name:WEILER
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:402-955-6826
Mailing Address - Street 1:PO BOX 30265
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68103-1365
Mailing Address - Country:US
Mailing Address - Phone:800-411-7538
Mailing Address - Fax:817-334-0235
Practice Address - Street 1:8200 DODGE STREET
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4113
Practice Address - Country:US
Practice Address - Phone:402-955-4303
Practice Address - Fax:402-955-4300
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NPPI - ANESTHESIOLOGY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-11-05
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207LP3000X
NE367500000X, 207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric AnesthesiologyGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty