Provider Demographics
| NPI: | 1295777225 |
|---|---|
| Name: | CREIGHTON UNIVERSITY |
| Entity type: | Organization |
| Organization Name: | CREIGHTON UNIVERSITY |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | VICE PRESIDENT |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | DANIEL |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | BURKEY |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 402-280-2131 |
| Mailing Address - Street 1: | 2500 CALIFORNIA PLZ |
| Mailing Address - Street 2: | |
| Mailing Address - City: | OMAHA |
| Mailing Address - State: | NE |
| Mailing Address - Zip Code: | 68178-0001 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 2500 CALIFORNIA PLZ |
| Practice Address - Street 2: | |
| Practice Address - City: | OMAHA |
| Practice Address - State: | NE |
| Practice Address - Zip Code: | 68178-0001 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 402-280-5877 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-06-12 |
| Last Update Date: | 2008-01-21 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207RA0201X | Allopathic & Osteopathic Physicians | Internal Medicine | Allergy & Immunology | Group - Single Specialty |
| No | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Single Specialty | |
| No | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | Group - Single Specialty | |
| No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Single Specialty | |
| No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Single Specialty |
| No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Single Specialty |
| No | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | Group - Single Specialty |
| No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Single Specialty |
| No | 207RI0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | Group - Single Specialty |
| No | 207RN0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | Group - Single Specialty |
| No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Single Specialty |
| No | 207RR0500X | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | Group - Single Specialty |
| No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Single Specialty | |
| No | 207ZP0102X | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology | Group - Single Specialty |
| No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Single Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| NE | 099256 | Medicare PIN | |
| NE | 093285 | Medicare PIN | |
| NE | 086032 | Medicare PIN | |
| NE | 098355 | Medicare PIN | |
| NE | 086154 | Medicare PIN | |
| NE | 086309 | Medicare PIN | |
| NE | 086160 | Medicare PIN | |
| NE | 092239 | Medicare PIN | |
| NE | 092240 | Medicare PIN | |
| NE | 086156 | Medicare PIN | |
| NE | 086157 | Medicare PIN | |
| NE | 097426 | Medicare PIN | |
| NE | 098393 | Medicare PIN | |
| NE | 098533 | Medicare PIN | |
| NE | 086153 | Medicare PIN | |
| NE | 086158 | Medicare PIN | |
| NE | 086159 | Medicare PIN | |
| NE | 092526 | Medicare PIN | |
| NE | 098948 | Medicare PIN | |
| NE | 098849 | Medicare PIN |
