| Charles Drew Health Center, Inc At Grant Street | |
|
2915 Grant Street Omaha NE 68111-3863 | |
| (402) 451-3553 | |
| (402) 457-1220 |
| Full Name | Charles Drew Health Center, Inc At Grant Street |
|---|---|
| Speciality | Clinic/Center |
| Location | 2915 Grant Street, Omaha, Nebraska |
| Authorized Official Name and Position | Andre Stringfellow (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 4024571215 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles Drew Health Center, Inc At Grant Street Po Box 30019 2915 Grant Street Omaha NE 68103-1119 Ph: (402) 451-3553 | Charles Drew Health Center, Inc At Grant Street 2915 Grant Street Omaha NE 68111-3863 Ph: (402) 451-3553 |
| NPI Number | 1255302170 |
|---|---|
| Provider Enumeration Date | 01/30/2006 |
| Last Update Date | 07/11/2024 |
| Certification Date | 07/11/2024 |
| Medicare PECOS PAC ID | 9830170653 |
|---|---|
| Medicare Enrollment ID | O20040527000621 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255302170 | NPI | - | NPPES |
| Provider Name | Arlana Rose Phillips |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952418022 PECOS PAC ID: 1456333178 Enrollment ID: I20040604000834 |
| Provider Name | Shashi K Bhatia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265546949 PECOS PAC ID: 8022027606 Enrollment ID: I20060410000310 |
| Provider Name | Sydney Buckland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104828326 PECOS PAC ID: 7618910704 Enrollment ID: I20070216000489 |
| Provider Name | Sheritta Ann Strong |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437231800 PECOS PAC ID: 5294893822 Enrollment ID: I20081024000689 |
| Provider Name | Traci L Jenkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881927655 PECOS PAC ID: 0244370625 Enrollment ID: I20091215000584 |
| Provider Name | Madeline J West |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285686212 PECOS PAC ID: 4183751704 Enrollment ID: I20100429000783 |
| Provider Name | Brenda I Avant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275737058 PECOS PAC ID: 3678601549 Enrollment ID: I20100513000619 |
| Provider Name | William J Ostdiek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477603470 PECOS PAC ID: 2365571718 Enrollment ID: I20100525000065 |
| Provider Name | Christopher M Glowacki |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225232119 PECOS PAC ID: 2567633126 Enrollment ID: I20110913000073 |
| Provider Name | Christy Boulos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407131543 PECOS PAC ID: 7315104908 Enrollment ID: I20120209000470 |
| Provider Name | Gregory U Ochuba |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598870057 PECOS PAC ID: 0749440329 Enrollment ID: I20120320000545 |
| Provider Name | Sonia Acharya-gupta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437345329 PECOS PAC ID: 9335265651 Enrollment ID: I20141216001182 |
| Provider Name | Camille D Brewer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740395219 PECOS PAC ID: 4385790179 Enrollment ID: I20150526001843 |
| Provider Name | Supriya Kumari Bhatia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326209024 PECOS PAC ID: 5395995237 Enrollment ID: I20160720002210 |
| Provider Name | Souhel B Askar |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1578931457 PECOS PAC ID: 0840579603 Enrollment ID: I20161118000104 |
| Provider Name | Molly E Cawley |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1992110696 PECOS PAC ID: 7416237672 Enrollment ID: I20161205000612 |
| Provider Name | Jillian Wallen |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1750555793 PECOS PAC ID: 0648556423 Enrollment ID: I20170410001264 |
| Provider Name | Leslie Irene Dvorak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265422562 PECOS PAC ID: 8921385097 Enrollment ID: I20170428000371 |
| Provider Name | Matthew A Halfar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184916744 PECOS PAC ID: 5496974081 Enrollment ID: I20170522000057 |
| Provider Name | Mark Alan Darby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851812309 PECOS PAC ID: 1557633849 Enrollment ID: I20170822000778 |
| Provider Name | Co Thi Ho |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912317694 PECOS PAC ID: 6406128693 Enrollment ID: I20170823001548 |
| Provider Name | Morgan Elizabeth Freilich |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1952830531 PECOS PAC ID: 3870863947 Enrollment ID: I20171122001287 |
| Provider Name | Melissa Lynn Howey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194238378 PECOS PAC ID: 2466719992 Enrollment ID: I20171207002797 |
| Provider Name | Bryan Skar |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1417185141 PECOS PAC ID: 4587923842 Enrollment ID: I20180111001487 |
| Provider Name | Tiffany Danielle Felder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407381478 PECOS PAC ID: 6305115841 Enrollment ID: I20180817001408 |
| Provider Name | Deandre Lee Bluitt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861875460 PECOS PAC ID: 5092003962 Enrollment ID: I20190408002786 |
| Provider Name | Aaron Mccoy |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1295228740 PECOS PAC ID: 4284967340 Enrollment ID: I20190605002334 |
| Provider Name | Melissa H O'dell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588030092 PECOS PAC ID: 0345520722 Enrollment ID: I20190617001862 |
| Provider Name | Claire Christine Koukol |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1699296707 PECOS PAC ID: 7911231477 Enrollment ID: I20190703000725 |
| Provider Name | Jyotsna S Ranga |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578666988 PECOS PAC ID: 7315103934 Enrollment ID: I20190918000889 |
| Provider Name | Stefanie S Till |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215589395 PECOS PAC ID: 2567793086 Enrollment ID: I20200611001156 |
| Provider Name | Deyanna Boston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689100539 PECOS PAC ID: 2264760628 Enrollment ID: I20200619000355 |
| Provider Name | Ashley M Marreel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114301439 PECOS PAC ID: 7618282542 Enrollment ID: I20200713000343 |
| Provider Name | Abigail Lechner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841800505 PECOS PAC ID: 7719304450 Enrollment ID: I20200826003592 |
| Provider Name | Katie Lynn Sunde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346797792 PECOS PAC ID: 9234556598 Enrollment ID: I20200901001478 |
| Provider Name | Benjamin Kneale Reimer |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1821584566 PECOS PAC ID: 9638599517 Enrollment ID: I20201014001933 |
| Provider Name | Emily Strunk |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1134772551 PECOS PAC ID: 7719398817 Enrollment ID: I20201120001825 |
| Provider Name | Erin Merrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992214076 PECOS PAC ID: 9830455302 Enrollment ID: I20210407000609 |
| Provider Name | Elisha A Mcdunn |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1245825041 PECOS PAC ID: 1951710482 Enrollment ID: I20210512002452 |
| Provider Name | Varun Sharma |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407137441 PECOS PAC ID: 1658650684 Enrollment ID: I20210602001628 |
| Provider Name | Taliat Abiodun Fawole |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255795886 PECOS PAC ID: 2961740063 Enrollment ID: I20210714002477 |
| Provider Name | Sara Kathryn Zachman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245687201 PECOS PAC ID: 0244659324 Enrollment ID: I20210723002342 |
| Provider Name | Theresa Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477012029 PECOS PAC ID: 6608273909 Enrollment ID: I20210929003032 |
| Provider Name | Neissa Yacoubou-coulibaly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013690627 PECOS PAC ID: 3274988506 Enrollment ID: I20231006000672 |
| Provider Name | Carmen Cooks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760864243 PECOS PAC ID: 0042657975 Enrollment ID: I20240327000848 |
| Provider Name | Jack Formanek |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285791376 PECOS PAC ID: 6709226186 Enrollment ID: I20240502000945 |
| Provider Name | Carla Habrich |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558817759 PECOS PAC ID: 9537448303 Enrollment ID: I20240502001239 |
| Provider Name | Ashlynn U Samuel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881073534 PECOS PAC ID: 0840630257 Enrollment ID: I20240502001879 |
| Provider Name | Shelina S Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437277613 PECOS PAC ID: 5193267367 Enrollment ID: I20240604002247 |
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Hill Counseling And Consulting, P.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1941 S 42nd St, Suite 129, Omaha, NE 68105 Phone: 402-871-9979 Fax: 402-614-9947 | |
Deborah L. Winckler Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11330 Q St, Ste # 219, Omaha, NE 68137 Phone: 402-490-3672 Fax: 402-597-2349 | |
Serenity Psychodynamics, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11605 Arbor St, Suite 102, Omaha, NE 68144 Phone: 402-330-4700 Fax: 402-330-8815 | |
Completely Kids Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2566 Saint Marys Ave, Omaha, NE 68105 Phone: 402-397-5809 |