1851309843 NPI number — JOEL D ELSON MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851309843 NPI number — JOEL D ELSON MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ELSON
Provider First Name:
JOEL
Provider Middle Name:
D
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851309843
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4460
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OMAHA
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68104
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
866-491-5807
Provider Business Mailing Address Fax Number:
913-491-0411

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16901 LAKESIDE HILLS CT
Provider Second Line Business Practice Location Address:
ALEGENT LAKESIDE - DEPT OF RADIOLOGY
Provider Business Practice Location Address City Name:
OMAHA
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68130-2318
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-717-8146
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  14706 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2085R0202X , with the licence number: 21690 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 14706 . This is a "LICENSE NUMBER" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 1602793 . This is a "UHC SHARE ALLIANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1602795 . This is a "UHC SHARE ALLIANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1602797 . This is a "UHC SHARE ALLIANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 21690 . This is a "LICENSE NUMBER" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 3957 . This is a "MIDLANDS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1602794 . This is a "UHC SHARE ALLIANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 12161953 . This is a "DOB" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1602773 . This is a "UHC SHARE ALLIANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 06265 . This is a "BCBS" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 1602796 . This is a "UHC SHARE ALLIANCE" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com