Basic Information
Provider Information | |||||||||
NPI: | 1447211271 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | NEXION HEALTH AT OMAHA, INC. | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: | OMAHA HEALTHCARE CENTER | ||||||||
OtherOrganizationType: | 3 | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 1430 PROGRESS WAY | ||||||||
Address2: | SUITE 108 | ||||||||
City: | ELDERSBURG | ||||||||
State: | MD | ||||||||
PostalCode: | 217846429 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4105524800 | ||||||||
FaxNumber: | 4105524837 | ||||||||
Practice Location | |||||||||
Address1: | 205 GILES ST | ||||||||
Address2: |   | ||||||||
City: | OMAHA | ||||||||
State: | TX | ||||||||
PostalCode: | 755714013 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9038842358 | ||||||||
FaxNumber: | 9038843102 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 03/31/2006 | ||||||||
LastUpdateDate: | 08/22/2020 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | KIRLEY | ||||||||
AuthorizedOfficialFirstName: | FRANCIS | ||||||||
AuthorizedOfficialMiddleName: | P | ||||||||
AuthorizedOfficialTitleorPosition: | PRESIDENT & CEO | ||||||||
AuthorizedOfficialTelephone: | 4105524800 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 114880 | TX | Y |   | Nursing & Custodial Care Facilities | Skilled Nursing Facility |   |
ID Information
ID | Type | State | Issuer | Description | 004801 | 01 | TX | STATE VENDOR NUMBER | OTHER | 1611196 | 05 | TX |   | MEDICAID |