OMAHA NEPHROLOGY PC NPI 1053407064

NPI Information

  • NPI: 1053407064
  • Provider Name: OMAHA NEPHROLOGY PC
  • Classification: Internal Medicine - 207RN0300X
  • Specialization: Nephrology
  • Entity Type: Organization
  • Address: 1111 N 102ND CT STE 200
    OMAHA, NE
    ZIP 68114
  • Phone: (402) 502-2747

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NPI Details

OMAHA NEPHROLOGY PC is a nephrology internal medicine in Omaha, NE. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. OMAHA NEPHROLOGY PC NPI is 1053407064. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1111 N 102ND CT STE 200
OMAHA, NE
ZIP 68114-194
Phone: (402) 502-2747
Fax: (402) 502-2387

The provider's authorized official is David C Goldner .
The authorized official title is Authorized Official and has the following contact phone number (402) 502-2747.

The enumeration date for this NPI number is 10/5/2006 and was last updated on 4/10/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RN0300XInternal MedicineNephrologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1CD3083OTHERNEBRASKARAILROAD MEDICARE
20993865MEDICAIDIOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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