Provider Demographics
NPI:1659461895
Name:NEBRASKA METHODIST HOSPITAL
Entity Type:Organization
Organization Name:NEBRASKA METHODIST HOSPITAL
Other - Org Name:METHODIST HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT & COO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:GOESER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-354-4449
Mailing Address - Street 1:PO BOX 2797
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68103-2797
Mailing Address - Country:US
Mailing Address - Phone:402-354-4230
Mailing Address - Fax:402-354-6171
Practice Address - Street 1:8303 DODGE STREET
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114
Practice Address - Country:US
Practice Address - Phone:402-354-4000
Practice Address - Fax:402-354-8735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE260008273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0901108Medicaid
NE5000043OtherUHC
NE00077OtherBCBS OF NE
NE=========87Medicaid
IA0901108Medicaid
NE28-T040Medicare ID - Type Unspecified