Organization
MD WEST ONE, PC
Active
Other names
MD West ONE, PC
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER FREDRICKS (BUSINESS OFFICE SUPERVISOR)
(402) 361-5670
Entity
Organization
Contact information
Practice address
8005 FARNAM DR STE 305, OMAHA, NE 68114-3426
(402) 390-4111
(402) 390-4115
Mailing address
8005 FARNAM DR STE 305, OMAHA, NE 68114-3426
(402) 390-4111
(402) 390-4115
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207T00000X
Neurological Surgery Physician
Primary
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0532945
—
IA
01
—
CO4224
RR MEDICARE
—
Enumeration date
05/16/2006
Last updated
11/03/2025
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