Organization
ORTHOWEST LLC
Active
Other names
OrthoWest, OrthoNebraska Clinics
Organization subpart
No
Provider details
NPI number
Authorized official
TARA WISDOM (CHIEF REVENUE AND ADMIN. OFFICER)
(402) 609-1002
Entity
Organization
Contact information
Practice address
3415 S 205TH ST, ELKHORN, NE 68022-3509
(402) 609-3000
Mailing address
2725 S 144TH ST STE 212, OMAHA, NE 68144-5253
(402) 609-3000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
01/07/2025
Last updated
06/04/2025
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