ALEGENT HEALTH LAKESIDE IDTF – NPI #1417975483
Radiology

A Radiology doctor of Osteopathy that specializes in Body Imaging.

Health Care Provider Taxonomy Code for Radiology

ALEGENT HEALTH LAKESIDE IDTF is a radiologist located in OMAHA, NE. NPPES has assigned the NPI number 1417975483 to ALEGENT HEALTH LAKESIDE IDTF on July 18, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “ALEGENT HEALTH LAKESIDE IDTF” is a dba name, the actual legal business name for this organization is ALEGENT CREIGHTON HEALTH. This provider is also associated with 2 additional names listed below. The primary taxonomy selected by this provider is 2085B0100X from the Health Care Provider Taxonomy code set, which is classified as Radiology, specializing in Body Imaging

The NPI profile was last updated on Dec 09, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ALEGENT HEALTH LAKESIDE IDTF below.

NPI Profile for
ALEGENT CREIGHTON HEALTH

NPI Number
1417975483
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ALEGENT CREIGHTON HEALTH
Doing Business As (dba): ALEGENT HEALTH LAKESIDE IDTF
Other name(s)
All associated names:
Doing Business As (dba)
ALEGENT HEALTH LAKESIDE IDTF
Doing Business As (dba)
CHI Health Lakeside Imaging
Primary location
17030 LAKESIDE HILLS PLZ
OMAHA, NE 68130-2396
Phone: (402) 758-5060 Fax: (402) 758-5079
Mailing address
PO BOX 772650
CHICAGO, IL 60677-0001
Phone: (402) 717-4377 Fax: (402) 717-4317
Organization Subpart
No
Authorized Official
TIM BRICKER
CEO
Phone: (541) 610-8147
Updated
Certification Date
Dec 09, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2085B0100X
- Radiology / Body Imaging (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.