STATE OF NEBRASKA ROSTER HEALTH CLINICS Department of Health and Human Division of Public Health, Licensure Unit 301 Centennial Mall South-Third Floor PO Box 94986 Lincoln, NE 68509-4986 Health Clinics Licenses Expire February 28, of each year
NEBRASKA HEALTH CLINICS Total Licensed Facilities Ambulatory Surgical Centers-Licensure Only 1 Ambulatory Surgical Centers-Medicare Certified 45 Health Clinics/Public Health Clinics 28 Hemodialysis Facilities 36 TOTAL HEALTH CLINICS 110 LEGEND ---------- ASC-L ----------- ---------- ------- TJC -------------- HC ---------------- -------------- Ambulatory Surgical Center - Medicare Certified Ambulatory Surgical Center - Licensure Only Association for Ambulatory Health Care End Stage Renal Dialysis - Medicare Certified The Joint Commission Health Clinic - Licensure Only Public Health Clinic Please contact the Licensure Unit or the provider to determine current Medicare status Updated: 07/02/2015
Page 2 of 24 ALLIANCE (BOX BUTTE) - 69301 BOX BUTTE DIALYSIS UNIT P O BOX 810, 2101 BOX BUTTE AVENUE (308) 762-6660 FAX: (308) 762-1923 BOX BUTTE GENERAL HOSPITAL DANIEL GREISS, ADMINISTRATOR ESRD024 BEATRICE (GAGE) - 68310 Bsdc Public Health Clinic 3000 LINCOLN STREET (402) 223-6600 FAX: (402) 223-8529 STATE OF NEBRASKA HEALTH & HUMAN SERVICES SYSTEM TODD STULL, ADMINISTRATOR HC049 BELLEVUE (SARPY) - 68005 BELLEVUE HEALTH CENTER 1002 WEST MISSION (402) 292-4164 FAX: (402) 292-4643 LEROY H. CARHART, M.D. MARY CARHART, ADMINISTRATOR HC HC001 BELLEVUE (SARPY) - 68005 Cornhusker Dialysis 505 CORNHUSKER RD, SUITE 107 (402) 292-2813 FAX: (402) 292-2823 DVA RENAL HEALTHCARE, INC. CHRISTY BAKER ESRD058 REUSE c/o: DAVITA, INC - ATTN REGINA COPELAND LICENSURE & CERTIFICATION, 5200 VIRGINIA WAY, BRENTWOOD TN BELLEVUE (SARPY) - 68123 DIALYSIS CLINIC, INC ESRD041 4112 TWIN CREEK DRIVE (402) 934-9560 FAX: (402) 934-9606 DIALYSIS CLINIC, INC TERRY DALTON c/o: DIALYSIS CLINIC, INC 3316 DODGE STREET, OMAHA NE 68131
Page 3 of 24 BELLEVUE (SARPY) - 68005 HEARTLAND CATARACT & LASER SURGERY CENTER, INC 1103 GALVIN ROAD SOUTH (402) 292-6514 FAX: (402) 292-7122 HAROLD R. BARES M.D. HAROLD BARES M.D., ADMINISTRATOR ASC029 BELLEVUE (SARPY) - 68123 HC/L&D The Midwife's Place HC058 3512 SAMSON WAY, SUITE 106 (402) 934-8288 FAX: (402) 934-8290 HEATHER RAMSEY CNM & BRIAN FINLEY MD HEATHER RAMSEY, ADMINISTRATOR c/o: HEATHER RAMSEY CNM 822 BORDEAUX AVENUE, BELLEVUE NE 68123 LABOR AND DELIVERY SERVIC BELLEVUE (SARPY) - 68123 HC Total Sleep Center HC065 2510 BELLEVUE MEDICAL CENTER DRIVE, STE 170 (402) 991-7832 FAX: (402) 991-7981 TOTAL SLEEP CENTER TIM GOODLETT, ADMINISTRATOR c/o: TOTAL SLEEP CENTER 5950 S 118TH CIRCLE, OMAHA NE 68137 CHADRON (DAWES) - 69337 CHADRON COMMUNITY HOSPITAL AND HEALTH SERVICES 825 CENTENNIAL DRIVE (308) 432-5586 FAX: (308) 432-2737 CHADRON COMMUNITY HOSPITAL CORP. SHANE NORMAN, ADMINISTRATOR ESRD052 CHADRON (DAWES) - 69337 WCHR - FAMILY REPRODUCTIVE HEALTH SERVICES HC068 300 SHELTON STREET (308) 432-8979 FAX: (308) 432-8974 CHADRON COMMUNITY HOSPITAL CORP. HAROLD KRUEGER JR, ADMINISTRATOR WCHR - ATTN SANDY ROES, 300 SHELTON STREET, CHADRON NE 69337 BRANCH/EXTENSION/OFFSITE: 11 PADDOCK - CRAWFORD BRANCH/EXTENSION/OFFSITE: 106 N MAIN STREET - GORDON BRANCH/EXTENSION/OFFSITE: 619 BOX BUTTE AVENUE - ALLIANCE
Page 4 of 24 COLUMBUS (PLATTE) - 68601 Columbus Surgery Center, LLC ASC047 3772 43RD AVENUE, SUITE B (402) 562-8795 FAX: (402) 563-2765 PETER E. DIEDRICHSEN, MD BILLI BENSON, ADMINISTRATOR c/o: BILLI BENSON COLUMBUS SURGERY CENTER, LLC, P O BOX 1302, COLUMBUS NE 68601 COLUMBUS (PLATTE) - 68601 DIALYSIS CENTER OF COLUMBUS ESRD020 2452 39TH AVENUE (402) 563-2139 FAX: (402) 563-9145 DIALYSIS CENTER OF LINCOLN, INC LARRY EMERSON, ADMINISTRATOR c/o: DIALYSIS CENTER OF LINCOLN 7910 O STREET, LINCOLN NE 68510 FREMONT (DODGE) - 68025 DODGE COUNTY DIALYSIS 1949 EAST 23RD AVENUE SOUTH (402) 721-7005 FAX: (402) 721-7480 DVA RENAL HEALTHCARE, INC. CINDY CLAUSEN, ADMINISTRATOR ESRD050 c/o: DAVITA, INC - ATTN REGINA COPELAND LICENSURE & CERTIFICATION, 5200 VIRGINIA WAY, BRENTWOOD TN FREMONT (DODGE) - 68025 RAI Care Centers d/b/a RAI-North Healthy Way-Fremont 2660 NORTH HEALTHY WAY (402) 721-1158 FAX: (402) 721-0324 RAI CARE CENTERS OF NEBRASKA II, LLC CINDY HOFFMAN, ADMINISTRATOR ESRD051 PERITONEAL DIALYSIS FREMONT (DODGE) - 68025 SURGERY CENTER OF FREMONT, LLC ASC007 2727 NORTH CLARKSON STREET (402) 727-8500 FAX: (402) 721-1065 SURGERY CENTER OF FREMONT, LLC TONYA HEMMER, ADMINISTRATOR c/o: SURGERY CENTER OF FREMONT, LLC 333 W. WACKER DRIVE, SUITE 1010, CHICAGO IL 60606
Page 5 of 24 FREMONT (DODGE) - 68025 Three Rivers District Health Department 2400 NORTH LINCOLN (402) 727-5396 FAX: (402) 727-5399 THREE RIVERS PUBLIC HEALTH DEPARTMENT TERRA UHING, INTERIM ADMINIS HC061 BRANCH/EXTENSION/OFFSITE: 739 WEST 10TH STREET, SUITE B - WAHOO GERING (SCOTTS BLUFF) - 69341 Community Action Partnership of Western Nebraska HC023 975 CRESCENT DRIVE (308) 632-2540 FAX: (308) 633-2650 COMMUNITY ACTION PARTNERSHIP OF WESTERN NEBRASKA JANICE FITTS, ADMINISTRATOR c/o: HEALTH CENTER CAPWN HEALTH CENTER, 3350 10TH STREET, GERING NE 69341 BRANCH/EXTENSION/OFFSITE: 619 BOX BUTTE AVE-LTD USE TUES JUN/OCT - ALLIANCE BRANCH/EXTENSION/OFFSITE: 221 CHADRON AVENUE - CHADRON GRAND ISLAND (HALL) - 68801 CENTRAL HEALTH CENTER HC054 217 EAST STOLLEY PARK ROAD, SUITE E (308) 384-7625 FAX: (308) 384-8904 CENTRAL HEALTH CENTER, INC JANET NELSON, ADMINISTRATOR c/o: CENTRAL HEALTH CENTER P O BOX 2539, GRAND ISLAND NE 68802 BRANCH/EXTENSION/OFFSITE: 1308 NORTH ADAMS - LEXINGTON BRANCH/EXTENSION/OFFSITE: 2337 NORTH WEBB ROAD - GRAND ISLAND BRANCH/EXTENSION/OFFSITE: 4503 2ND AVE, STE 209 - KEARNEY GRAND ISLAND (HALL) - 68801 GRAND ISLAND DIALYSIS 203 EAST STOLLEY PARK ROAD, SUITE G (308) 384-4067 FAX: (308) 382-0461 RENAL TREATMENT CENTERS-ILLINOIS, INC DANIEL FINKENBINDER, ADMINISTRATOR ESRD057 c/o: DAVITA, INC - ATTN REGINA COPELAND LICENSURE & CERTIFICATION, 5200 VIRGINIA WAY, BRENTWOOD TN HOME HOME PERITONEAL DIALYSIS GRAND ISLAND (HALL) - 68802 GRAND ISLAND SURGERY CENTER ASC008 P O BOX 5434, 3610 RICHMOND CIRCLE (308) 384-6400 FAX: (308) 398-6420 GRAND ISLAND SURGICAL CENTER, LLC KEN TERRY, ADMINISTRATOR c/o: GRAND ISLAND SURGICAL CENTER, LLC P O BOX 5434, GRAND ISLAND NE 68802
Page 6 of 24 GRAND ISLAND (HALL) - 68803 Heartland Health Center, Inc 3307 WEST CAPITAL AVENUE (308) 382-4297 FAX: (308) 382-4376 HEARTLAND HEALTH CENTER, INC TERRI FORD-WOLFGRAM, ADMINISTRATOR HC069 GRAND ISLAND (HALL) - 68803 KIDNEY DIALYSIS CENTER OF GRAND ISLAND ESRD047 3516 RICHMOND CIRCLE (308) 384-9600 FAX: (308) 384-9601 RCG GRAND ISLAND, LLC TRACI LUDOWISE, ADMINISTRATOR c/o: KIDNEY DIALYSIS OF GRAND ISLAND 3516 RICHMOND CIRCLE, GRAND ISLAND NE 68803 HOME PERITONEAL DIALYSIS HASTINGS (ADAMS) - 68901 HASTINGS DIALYSIS CENTER 1900 NORTH ST. JOSEPH AVENUE (402) 463-4893 FAX: (402) 463-7049 RENAL TREATMENT CENTERS-ILLINOIS, INC DANIEL FINKENBINDER, ADMINISTRATOR ESRD002 HOME PERITONEAL DIALYSIS c/o: DAVITA, INC - ATTN REGINA COPELAND LICENSURE & CERTIFICATION, 5200 VIRGINIA WAY, BRENTWOOD TN HASTINGS (ADAMS) - 68901 HASTINGS FAMILY PLANNING HC072 606 NORTH MINNESOTA AVE, SUITE #1 (402) 463-5687 FAX: (402) 463-5021 THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION SHAWN RIGGS, ADMINISTRATOR c/o: SHAWN J. RIGGS, VICE PRESIDENT 715 NORTH ST JOSEPH AVENUE, HASTINGS NE 68901 HASTINGS (ADAMS) - 68901 HASTINGS LASER & EYE SURGERY CENTER 715 NORTH KANSAS, SUITE 303 (402) 462-5888 FAX: (402) 462-6874 HASTINGS LASER & EYE SURGERY CENTER, LLC DENISE KRUEGER, ADMINISTRATOR ASC009
Page 7 of 24 HASTINGS (ADAMS) - 68901 Hastings Surgical Center, Llc 5803 OSBORNE DR WEST (402) 462-5440 FAX: (402) 462-5444 HASTINGS SURGICAL CENTER LLC BROOK DAY, ADMINISTRATOR ASC043 KEARNEY (BUFFALO) - 68848 FIRST SURGICENTER ASC006 3500 CENTRAL AVENUE, SUITE B (308) 865-1419 FAX: (308) 865-1445 HEALTH SERVICE ONE, P.C. GREG GANGWISH, ADMINISTRATOR c/o: HEALTH SERVICE ONE, P. C. FIRST SURGICENTER, PO BOX 2168, KEARNEY NE 68848 KEARNEY (BUFFALO) - 68845 HEARTLAND SURGERY CENTER 3515 30TH AVENUE (308) 865-2670 FAX: (308) 865-2876 KEARNEY AMBULATORY SURGICAL CENTER, LLC DBA HEARTL ANITA HUDDLESTON, ADMINISTRATOR ASC030 KEARNEY (BUFFALO) - 68845 Kearney Eye Surgical Center Inc 411 W 39TH STREET, SUITE 2 (308) 865-2759 FAX: (308) 865-2755 KEARNEY EYE SURGICAL CENTER INC NICK ABEGGLEN, ADMINISTRATOR ASC051 KEARNEY (BUFFALO) - 68847 Kearney Pain Treatment Center Llc 920 EAST 56TH STREET, SUITE D (308) 455-3091 FAX: (308) 455-3093 MED-CARE, INC: NORTH PLATTE ANESTHESIA ASSOCIATES, DARIAN PIKE, ADMINISTRATOR ASC069
Page 8 of 24 KEARNEY (BUFFALO) - 68847 Kearney Sleep Lab, Llc 109 EAST 52ND STREET, SUITE 2 (308) 455-1331 FAX: (308) 225-5491 KEARNEY SLEEP LAB, LLC MELISSA HINSLEY, ADMINISTRATOR 12140 ROBERTS ROAD, LAVISTA NE 68128 HC HC066 KEARNEY (BUFFALO) - 68847 OVERLAND TRAILS RENAL CARE GROUP 5210 PARKLANE DRIVE (308) 233-5011 FAX: (308) 233-5017 OVERLAND TRAILS RENAL CARE GROUP, LLC SHELLI VEST, ADMINISTRATOR ESRD038 HOME PERITONEAL DIALYSIS LINCOLN (LANCASTER) - 68503 CAPITAL CITY DIALYSIS 307 NORTH 46TH STREET (402) 466-5123 FAX: (402) 466-8351 RENAL TREATMENT CENTERS-ILLINOIS, INC AMBER GISH, ADMINISTRATOR ESRD003 HOME HOME PERITONEAL DIALYSIS PERITONEAL DIALYSIS REUSE c/o: DAVITA, INC - ATTN REGINA COPELAND LICENSURE & CERTIFICATION, 5200 VIRGINIA WAY, BRENTWOOD TN LINCOLN (LANCASTER) - 68510 DIALYSIS CENTER OF LINCOLN 7910 O STREET (402) 489-5339 FAX: (402) 489-7366 DIALYSIS CENTER OF LINCOLN, INC LARRY EMERSON, ADMINISTRATOR ESRD021 LINCOLN (LANCASTER) - 68512 Dialysis Center Of Lincoln Southwest ESRD049 5355 SOUTH 16TH STREET (402) 742-8500 FAX: (402) 328-9210 DIALYSIS CENTER OF LINCOLN, INC LARRY EMERSON, ADMINISTRATOR c/o: DIALYSIS CENTER OF LINCOLN, INC 7910 O STREET, LINCOLN NE 68510
Page 9 of 24 LINCOLN (LANCASTER) - 68521 DIALYSIS CENTER OF LINCOLN-NORTHWEST ESRD022 4911 NORTH 26TH STREET, SUITE 106 (402) 438-7330 FAX: (402) 438-3351 DIALYSIS CENTER OF LINCOLN, INC LARRY EMERSON, ADMINISTRATOR c/o: DIALYSIS CENTER OF LINCOLN 7910 O STREET, LINCOLN NE 68510 LINCOLN (LANCASTER) - 68512 Home Dialysis of Lincoln ESRD053 5355 SOUTH 16TH STREET (402) 742-8500 FAX: (402) 328-9210 HOME DIALYSIS OF LINCOLN, LLC LARRY EMERSON, ADMINISTRATOR c/o: DIALYSIS CENTER OF LINCOLN 7910 O STREET, LINCOLN NE 68510 HOME HOME PERITONEAL DIALYSIS LINCOLN (LANCASTER) - 68503 LINCOLN ENDOSCOPY CENTER, LLC ASC011 4545 R STREET, SUITE 101 (402) 465-4545 FAX: (402) 465-3621 LINCOLN ENDOSCOPY CENTER LLC SHARON TREAT, ADMINISTRATOR c/o: ADMINISTRATION DEPT LINCOLN ENDOSCOPY CENTER, 4545 R STREET, SUITE 201, LINCOLN NE 68503 LINCOLN (LANCASTER) - 68510 LINCOLN LANCASTER COUNTY HEALTH DEPT 3140 N STREET (402) 441-8000 FAX: (402) 441-8083 CITY OF LINCOLN JUDITH HALSTEAD, ADMINISTRATOR HC035 LINCOLN (LANCASTER) - 68506 LINCOLN SURGERY ENDOSCOPY SERVICES, LLC ASC035 1730 SOUTH 70TH STREET, SUITE 120 (402) 484-9050 FAX: (402) 483-5653 LINCOLN SURGERY ENDOSCOPY SERVICES, LLC ROBIN LINAFELTER, ADMINISTRATOR c/o: LINCOLN SURGERY ENDOSCOPY SERVICES, LLC 1710 SOUTH 70TH STREET, SUITE 200, LINCOLN NE 68506
Page 10 of 24 LINCOLN (LANCASTER) - 68510 LOC SURGERY CENTER, INC 6900 A STREET, SUITE 200 (402) 436-2012 FAX: (402) 436-2090 LOC SURGERY CENTER, INC DOUGLAS WYATT, ADMINISTRATOR ASC025 LINCOLN (LANCASTER) - 68510 NEBRASKA SURGERY CENTER, LLC 625 SOUTH 70TH STREET (402) 484-6600 FAX: (402) 484-6610 NEBRASKA SURGERY CENTER, LLC JANE HAIRE, ADMINISTRATOR ASC017 LINCOLN (LANCASTER) - 68521 NEBRASKA URBAN INDIAN MEDICAL CENTER 2331 FAIRFIELD STREET (402) 434-7177 FAX: (402) 434-7180 NEBRASKA URBAN INDIAN HEALTH COALITION, INC DONNA POLK-PRIMM, ADMINISTRATOR HC041 LINCOLN (LANCASTER) - 68506 OMEGA SURGERY CENTERS, LLC 1500 SOUTH 48TH STREET, SUITE 612 (402) 483-4448 FAX: (402) 483-4750 OMEGA SURGERY CENTER, LLC KELLIE JOHNSON, ADMINISTRATOR ASC024 c/o: STEWART SOLSKY, OPERATIONS MANAGER OMEGA SURGERY CENTER, 1500 SOUTH 48TH STREET, SUITE 612, LINCOLN NE 68506 LINCOLN (LANCASTER) - 68503 PEOPLE'S HEALTH CENTER 1021 NORTH 27TH STREET (402) 476-1455 FAX: (402) 476-1655 PEOPLE'S HEALTH CENTER, INC BRAD MEYER, ADMINISTRATOR HC039 BRANCH/EXTENSION/OFFSITE: 2201 SOUTH 17TH STREET - LINCOLN BRANCH/EXTENSION/OFFSITE: 2246 O STREET - LINCOLN
Page 11 of 24 LINCOLN (LANCASTER) - 68506 PHYSICIAN'S SURGICAL CENTER 1500 SOUTH 48TH STREET, SUITE 201 (402) 488-5812 FAX: (402) 488-1356 HEAD AND NECK SURGICAL PARTNERS, LLC KRISTIN WALLER, ADMINISTRATOR ASC022 LINCOLN (LANCASTER) - 68516 PLANNED PARENTHOOD OF THE HEARTLAND HC059 5631 SOUTH 48TH STREET, SUITE 100 (402) 441-3333 FAX: (402) 441-3337 PLANNED PARENTHOOD OF THE HEARTLAND JENNIFER WARREN-ULRICK, ADMINISTRATOR c/o: PLANNED PARENTHOOD OF THE HEARTLAND 1171 7TH STREET, DES MOINES IA 50314 LINCOLN (LANCASTER) - 68510 SOMNOS LABORATORIES, INC 1101 SOUTH 70TH STREET, SUITE 102 (402) 486-3410 FAX: (402) 486-3356 SOMNOS LABORATORIES, INC. T TROY STENTZ, ADMINISTRATOR HC HC031 BRANCH/EXTENSION/OFFSITE: 2424 S LOCUST STREET, SUITE E - GRAND ISLAND LINCOLN (LANCASTER) - 68516 SOUTH LINCOLN DIALYSIS 3401 PLANTATION DRIVE, SUITE 140 (402) 421-6011 FAX: (402) 421-6052 RENAL TREATMENT CENTERS-ILLINOIS, INC AMBER GISH, ADMINISTRATOR ESRD048 REUSE c/o: DAVITA INC - ATTN REGINA COPELAND LICENSURE & CERTIFICATION, 5200 VIRGINIA WAY, BRENTWOOD TN LINCOLN (LANCASTER) - 68502 Southwest Lincoln Surgery Center, Llc 2222 S 16TH STREET, SUITE 315 (402) 475-3100 FAX: (402) 475-3109 SOUTHWEST LINCOLN SURGERY CENTER LLC CARLA LAUENSTEIN, ADMINISTRATOR ASC061
Page 12 of 24 LINCOLN (LANCASTER) - 68516 UROLOGY SURGICAL CENTER 5500 PINE LAKE ROAD (402) 421-8899 FAX: (402) 421-1945 UROLOGY SURGICAL CENTER SHERI SMITH, ADMINISTRATOR ASC028 MACY (THURSTON) - 68039 CARL T CURTIS HEALTH EDUCATION CENTER P O BOX 250, 100 INDIAN HILLS DRIVE (402) 837-5381 FAX: (402) 837-5303 OMAHA TRIBE OF NEBRASKA WEHNONA STABLER, ADMINISTRATOR HC042 MC COOK (RED WILLOW) - 69001 MCCOOK DIALYSIS CENTER 801 WEST C STREET (308) 345-1916 FAX: (308) 345-1928 RENAL TREATMENT CENTERS-ILLINOIS, INC JENNIFER STRONG ESRD037 PERITONEAL DIALYSIS REUSE c/o: DAVITA, INC - ATTN REGINA COPELAND LICENSURE & CERTIFICATION, 5200 VIRGINIA WAY, BRENTWOOD TN NORFOLK (MADISON) - 68701 FAITH REGIONAL SURGERY CENTER 301 NORTH 27TH STREET, SUITE 3 (402) 644-7262 FAX: (402) 644-7227 NORTHEAST NEBRASKA SURGERY CENTER, LLC CANDI EMANUEL, ADMINISTRATOR ASC019 NORFOLK (MADISON) - 68701 NE Nebraska Dialysis 1603 WEST PROSPECT AVENUE (402) 644-7592 FAX: (402) 644-7593 RENAL TREATMENT CENTERS-ILLINOIS, INC VICTORIA DENDINGER, ADMINISTRATOR ESRD055 c/o: DAVITA, INC - ATTN REGINA COPELAND LICENSURE & CERTIFICATION, 5200 VIRGINIA WAY, BRENTWOOD TN
Page 13 of 24 NORFOLK (MADISON) - 68701 SURGICENTER OF NORFOLK ASC023 3400 WEST NORFOLK AVENUE (402) 379-5555 FAX: (402) 379-5564 SURGICENTER OF NORFOLK CYNTHIA MILLER, ADMINISTRATOR c/o: SURGICENTER OF NORFOLK 3400 W NORFOLK AVE, NORFOLK NE 68701 NORTH PLATTE (LINCOLN) - 69101 NORTH PLATTE SURGERY CENTER, LLC 621 WEST FRANCIS (308) 534-5400 FAX: (308) 534-5469 NORTH PLATTE SURGERY CENTER, LLC SHIRLEY TORWIRT, ADMINISTRATOR ASC037 NORTH PLATTE (LINCOLN) - 69101 PEOPLE'S FAMILY HEALTH SERVICES, INC-FAMILY PLANNING 102 SOUTH ELM STREET (308) 534-3075 FAX: (308) 534-6104 PEOPLE'S FAMILY HEALTH SERVICES, INC. RACHEL STAHR, ADMINISTRATOR c/o: PEOPLE'S FAMILY HEALTH SVS, INC, FAMILY PLANNING 102 SOUTH ELM, NORTH PLATTE NE 69101 BRANCH/EXTENSION/OFFSITE: 111 West C Street - MC COOK NORTH PLATTE (LINCOLN) - 69101 RENAL CARE GROUP - NORTH PLATTE 785 EAST FRANCIS (308) 696-0941 FAX: (308) 696-0944 RCG NORTH PLATTE, LLC TRACI LUDOWISE, ADMINISTRATOR HC013 ESRD044 c/o: RENAL CARE GROUP - NORTH PLATTE ATTN: TRACI LUDOWISE, 785 EAST FRANCIS, NORTH PLATTE NE HOME HOME PERITONEAL DIALYSIS PERITONEAL DIALYSIS O' NEILL (HOLT) - 68763 AVERA ST ANTHONY'S HOSPITAL ESRD028 P O BOX 270, 300 NORTH 2ND STREET (402) 336-2611 FAX: (402) 336-5135 ST. ANTHONY'S HOSPITAL RONALD CORK, ADMINISTRATOR c/o: AVERA ST. ANTHONY'S HOSPITAL PO BOX 270, O'NEILL NE 68763
Page 14 of 24 OMAHA (DOUGLAS) - 68144 ADVANCED CENTER FOR SURGERY ASC001 2802 OAK VIEW DRIVE (402) 334-7546 FAX: (402) 334-8627 JOEL SCHLESSINGER, M.D. JOEL SCHLESSINGER, ADMINISTRATOR c/o: ADVANCED CENTER FOR SURGERY ATTN: JACKIE HALL MPAS-S, 2802 OAK VIEW DRIVE, OMAHA NE 68144 OMAHA (DOUGLAS) - 68102 ADVANCED SURGERY CENTER, LLC 111 S 10TH STREET (402) 345-1712 FAX: (402) 345-1864 ADVANCED SURGERY CENTER, LLC MARGARET SUMMERFELT, ADMINISTRATOR ASC042 OMAHA (DOUGLAS) - 68124 Bergan Mercy Surgery Center, Llc 7500 MERCY ROAD, SUITE 4300 (402) 398-6126 FAX: (402) 398-6606 BERGAN MERCY SURGERY CENTER, LLC LESLIE VOIGT, ADMINISTRATOR ASC064 OMAHA (DOUGLAS) - 68131 DIALYSIS CLINIC, INC. 3316 DODGE STREET (402) 342-0190 FAX: (402) 342-4199 DIALYSIS CLINIC, INC TERRY DALTON ESRD008 PERITONEAL DIALYSIS OMAHA (DOUGLAS) - 68164 DIALYSIS CLINIC, INC. 3015 NORTH 118TH CIRCLE (402) 493-9331 FAX: (402) 493-7677 DIALYSIS CLINIC, INC TERRY DALTON DIALYSIS CLINIC INC, 3316 DODGE STREET, OMAHA NE 68131 ESRD007 HOME HOME PERITONEAL DIALYSIS
Page 15 of 24 OMAHA (DOUGLAS) - 68105 Douglas County Health Department - Public Health Clinic HC060 1111 SOUTH 41ST STREET (402) 444-7471 FAX: (402) 444-6267 DOUGLAS COUNTY ADI POUR, ADMINISTRATOR c/o: DOUGLAS COUNTY HEALTH DEPARTMENT - PUBLIC HEALTH 1111 SOUTH 41ST STREET, OMAHA NE 68105 BRANCH/EXTENSION/OFFSITE: 1111 SOUTH 41ST STREET - OMAHA OMAHA (DOUGLAS) - 68137 Finkle Cosmetic Surgery Center PC 4911 S 118TH STREET (402) 926-2639 FAX: (402) 390-0893 DAVID R FINKLE, MD DAVID FINKLE, ADMINISTRATOR ASC058 AAAASF OMAHA (DOUGLAS) - 68127 HC Frontier Diagnostic Sleep Center HC067 8425 F STREET, SUITE B (402) 392-9947 FAX: (402) 339-9455 AMJ DAD LTD SYDNEY KLEIN, ADMINISTRATOR c/o: ATTN: SYDNEY KLEIN 304 WEST 8TH STREET, COZAD NE 69130 OMAHA (SARPY) - 68138 HEARTLAND CENTER FOR REPRODUCTIVE MEDICINE PC 7308 SOUTH 142ND STREET (402) 717-4220 FAX: (402) 717-4230 HEARTLAND CENTER FOR REPRODUCTIVE MEDICINE DEETTE STAEBELL, ADMINISTRATOR ASC-L ASC070 OMAHA (DOUGLAS) - 68137 Heartland Health Therapy 11011 Q STREET, SUITE 101C (402) 991-9933 FAX: (402) 926-4910 HEARTLAND HEALTH THERAPY INC JULIE BYRNE, ADMINISTRATOR HC HC073
Page 16 of 24 OMAHA (DOUGLAS) - 68137 JOHNSTON CENTER LLC 4909 SOUTH 118TH STREET (402) 397-2010 FAX: (402) 397-8439 JOHNSTON CENTER LLC MARK JOHNSTON, ADMINISTRATOR ASC040 OMAHA (DOUGLAS) - 68130 Lakeside Ambulatory Surgical Center, Llc 17030 LAKESIDE HILLS PLAZA, SUITE 110 (402) 758-5212 FAX: (402) 758-5215 LAKESIDE AMBULATORY SURGICAL CENTER LLC ANNA LAGSDING, ADMINISTRATOR ASC053 OMAHA (DOUGLAS) - 68130 Lakeside Endoscopy Center Llc 17001 LAKESIDE HILLS PLAZA, SUITE 201 (402) 614-2300 FAX: (402) 614-0123 LAKESIDE ENDOSCOPY CENTER LLC EDWIN SCHAFER, ADMINISTRATOR ASC054 TJC OMAHA (DOUGLAS) - 68198 M.M.I. U.N.M.C. (Pediatric Feeding Disorders & C.A.S.D. Prgm) 985450 NEBRASKA MEDICAL CENTER, SUITE 1047B (402) 559-6430 FAX: (402) 559-5737 BOARD OF REGENTS OF THE UNIVERSITY OF NEBRASKA MED J MICHAEL LEIBOWITZ, ADMINISTRATOR HC HC051 OMAHA (DOUGLAS) - 68118 Methodist Endoscopy Center, Llc 515 NORTH 162ND AVENUE, SUITE 201 (402) 504-3852 FAX: (402) 505-4738 METHODIST ENDOSCOPY CENTER, LLC TYRON ALLI, ADMINISTRATOR ASC063 TJC
Page 17 of 24 OMAHA (DOUGLAS) - 68114 MIDWEST ENDOSCOPY SERVICES, LLC 8901 INDIAN HILLS DRIVE, STE 100 (402) 933-1500 FAX: (402) 934-1612 MIDWEST ENDOSCOPY SERVICES, LLC BRAD SCHROEDER, ADMINISTRATOR ASC062 TJC OMAHA (DOUGLAS) - 68131 MIDWEST EYE SURGERY CENTER, LLC 4353 DODGE STREET (402) 552-2020 FAX: (402) 552-2367 MIDWEST EYE SURGERY CENTER, LLC JAY SLAGLE, ADMINISTRATOR ASC016 NONE OMAHA (DOUGLAS) - 68127 Midwest Surgery Center Inc ASC044 10784 V STREET (402) 502-5599 FAX: (402) 991-6766 DR. MICHAEL R. POWERS MICHAEL POWERS, ADMINISTRATOR c/o: MIDWEST SURGERY CENTER 10784 V STREET, OMAHA NE 68102 OMAHA (DOUGLAS) - 68154 MIRACLE HILLS SURGERY CENTER, LLC 11819 MIRACLE HILLS DRIVE, SUITE 201 (402) 884-2450 FAX: (402) 884-2455 MIRACLE HILLS SURGERY CENTER, LLC ANNE REMM, ADMINISTRATOR ASC034 OMAHA (DOUGLAS) - 68131 NAR Open MRI, LLC d/b/a Nebraska Advanced Radiology 117 NORTH 32ND AVENUE, SUITE 102 (402) 715-5200 FAX: (402) 715-5201 DANA, A NEBRASKA PARTNERSHIP/DJL IMAGING, LLC ROBIN NELSON HC HC055
Page 18 of 24 OMAHA (DOUGLAS) - 68114 Omaha Ambulatory Surgery Center LLP 825 NORTH 90TH STREET (402) 397-1180 FAX: (402) 408-1783 OMAHA CENTER LLP JEFF BIERLE, ADMINISTRATOR ASC010 NONE OMAHA (DOUGLAS) - 68131 OMAHA CENTRAL DIALYSIS 144 SOUTH 40TH STREET (402) 558-0818 FAX: (402) 558-2286 DVA RENAL HEALTHCARE, INC. KATE PRESTON ESRD025 c/o: DAVITA, INC - ATTN REGINA COPELAND LICENSURE & CERTIFICATION, 5200 VIRGINIA WAY, BRENTWOOD TN OMAHA (DOUGLAS) - 68112 Omaha Florence Dialysis 7454 NORTH 30TH STREET (402) 451-0723 FAX: (402) 453-0228 RENAL TREATMENT CENTERS-ILLINOIS, INC CINDY CLAUSEN, ADMINISTRATOR ESRD056 c/o: C/O DAVITA, INC - ATTN REGINA COPELAND LICENSURE & CERTIFICATION, 5200 VIRGINIA WAY, BRENTWOOD TN OMAHA (DOUGLAS) - 68135 Omaha Harrison Dialysis 6610 SOUTH 168TH STREET, SUITE 8 (402) 896-4609 FAX: (402) 896-1439 RENAL TREATMENT CENTERS-ILLINOIS, INC JENNIFER STRONG ESRD054 HOME HOME PERITONEAL DIALYSIS c/o: DAVITA, INC - ATTN REGINA COPELAND LICENSURE & CERTIFICATION, 5200 VIRGINIA WAY, BRENTWOOD TN OMAHA (DOUGLAS) - 68114 Omaha Home Training 8021 CASS STREET (402) 393-2346 FAX: (402) 391-1185 RENAL TREATMENT CENTERS-ILLINOIS, INC TRACY BABIN, ADMINISTRATOR 5200 VIRGINIA WAY - L & C DEPT, BRENTWOOD TN ESRD061 HOME HOME PERITONEAL DIALYSIS
Page 19 of 24 OMAHA (DOUGLAS) - 68107 OMAHA SOUTH DIALYSIS 3339 L STREET (402) 734-0772 FAX: (402) 734-0891 DVA RENAL HEALTHCARE, INC. JINETTE LICHTER, ADMINISTRATOR ESRD062 c/o: DAVITA, INC - ATTN REGINA COPELAND LICENSURE & CERTIFICATION, 5200 VIRGINIA WAY, BRENTWOOD TN OMAHA (DOUGLAS) - 68124 OMAHA SURGICAL CENTER 8051 WEST CENTER ROAD (402) 391-3333 FAX: (402) 391-8593 OSC LTD PARTNERSHIP JAMES QUINN, ADMINISTRATOR ASC020 OMAHA (DOUGLAS) - 68154 OMAHA WEST DIALYSIS 13014 WEST DODGE ROAD (402) 445-8950 FAX: (402) 445-8955 DVA RENAL HEALTHCARE, INC. PATRICK DENTON ESRD006 HOME PERITONEAL DIALYSIS c/o: DAVITA, INC - ATTN REGINA COPELAND LICENSURE & CERTIFICATION, 5200 VIRGINIA WAY, BRENTWOOD TN OMAHA (DOUGLAS) - 68154 OMEGA SURGERY CENTERS, LLC 11606 NICHOLAS STREET, SUITE 200 (402) 493-2020 FAX: (402) 493-8987 OMEGA HEALTH CENTERS, LLC KELLIE JOHNSON, ADMINISTRATOR ASC021
Page 20 of 24 OMAHA (DOUGLAS) - 68107 ONE WORLD COMMUNITY HEALTH CENTERS INC 4920 SOUTH 30TH STREET, SUITE 103 (402) 502-8845 FAX: (402) 991-5642 ONE WORLD COMMUNITY HEALTH CENTERS INC ANDREA SKOLKIN, ADMINISTRATOR HC018 TJC BRANCH/EXTENSION/OFFSITE: 4920 S 30TH STREET SUITE 103 - OMAHA BRANCH/EXTENSION/OFFSITE: 4215 SOUTH 20TH STREET - OMAHA BRANCH/EXTENSION/OFFSITE: 122 SOUTH 6TH STREET - PLATTSMOUTH BRANCH/EXTENSION/OFFSITE: 4700 GILES ROAD - BELLEVUE BRANCH/EXTENSION/OFFSITE: 3121 U STREET - OMAHA BRANCH/EXTENSION/OFFSITE: 2021 ST. MARY'S AVENUE - OMAHA BRANCH/EXTENSION/OFFSITE: 4229 NORTH 90TH STREET - OMAHA BRANCH/EXTENSION/OFFSITE: 4001 LEAVENWORTH - OMAHA BRANCH/EXTENSION/OFFSITE: 4101 SOUTH 120TH STREET - OMAHA BRANCH/EXTENSION/OFFSITE: 4910 SOUTH 30TH STREET - OMAHA BRANCH/EXTENSION/OFFSITE: 4930 SOUTH 30TH STREET - OMAHA OMAHA (DOUGLAS) - 68144 Outpatient Surgical Specialties Center Llc 11704 W CENTER ROAD, SUITE 110 (402) 691-1575 FAX: (402) 691-1599 OUTPATIENT SURGICAL SPECIALTIES CENTER, LLC LEAH EPPENBACH, ADMINISTRATOR ASC050 OMAHA (DOUGLAS) - 68152 Pace Nebraska 5755 SORENSON PKWY (402) 991-0330 FAX: (402) 991-0338 IMMANUEL BOBBI YOUNG, ADMINISTRATOR 6757 NEWPORT AVENUE, SUITE 200, OMAHA NE 68152 HC HC062 OMAHA (DOUGLAS) - 68114 Pacific Surgery Center, Llc 10707 PACIFIC STREET, SUITE 100 (402) 933-1844 FAX: (402) 932-5891 PACIFIC SURGERY CENTER LLC TIMOTHY FISCHER, ADMINISTRATOR ASC067
Page 21 of 24 OMAHA (DOUGLAS) - 68134 PLANNED PARENTHOOD OF THE HEARTLAND 3105 NORTH 93RD STREET (402) 496-6356 FAX: (402) 496-0489 PLANNED PARENTHOOD OF THE HEARTLAND JENNIFER WARREN-ULRICK, ADMINISTRATOR HC056 OMAHA (DOUGLAS) - 68164 POPP COSMETIC SURGERY P C 11919 GRANT STREET, SUITE 100 (402) 391-4558 FAX: (402) 391-7401 POPP COSMETIC SURGERY P C JEFFREY POPP, ADMINISTRATOR ASC032 OMAHA (DOUGLAS) - 68104 RAI Care Center d/b/a RAI-Ames-Omaha 5084 AMES AVENUE (402) 451-7745 FAX: (402) 451-8090 RAI CARE CENTERS OF NEBRASKA II, LLC CARROL JACKSON-WREN, RN ESRD043 OMAHA (DOUGLAS) - 68105 RAI CARE CENTER d/b/a/ RAI-CenterSt.-Omaha ESRD042 4411 CENTER DRIVE SUITE A (402) 558-3284 FAX: (402) 558-3114 RAI CARE CENTERS OF NEBRASKA II, LLC DIANE HEIMANN RD, LMNT, LD c/o: RENAL ADVANTAGE INC 4411 CENTER STREET, SUITE A, OMAHA NE 68105 HOME HOME PERITONEAL DIALYSIS OMAHA (DOUGLAS) - 68134 Sorensen Park Dialysis 6212 N 73RD PLAZA, SUITE 100 (402) 571-4147 FAX: (402) 573-9208 DVA RENAL HEALTHCARE, INC. KATELYN HILZ ESRD060 c/o: DAVITA, INC - ATTN REGINA COPELAND LICENSURE & CERTIFICATION, 5200 VIRGINIA WAY, BRENTWOOD TN
Page 22 of 24 OMAHA (DOUGLAS) - 68114 Surgi-Suite ASC002 8900 WEST DODGE ROAD (402) 390-0100 FAX: (402) 390-2711 SURGI-SUITE, INC RITA PETERSEN, ADMINISTRATOR c/o: SURGI-SUITE INC 8900 1/2 WEST DODGE ROAD, OMAHA NE 68114 OMAHA (DOUGLAS) - 68114 THE COLONOSCOPY CENTER INC 9850 NICHOLAS STREET, SUITE 100 (402) 392-6442 FAX: (402) 343-1177 THE COLONOSCOPY CENTER INC JESSICA QUICK, ADMINISTRATOR ASC038 OMAHA (DOUGLAS) - 68114 THE UROLOGY CENTER, P C 111 1/2 SOUTH 90TH STREET (402) 397-9800 FAX: (402) 397-7591 THE UROLOGY CENTER, P.C. LAURA FOREHEAD, ADMINISTRATOR ASC027 OMAHA (DOUGLAS) - 68118 Unmc Physicians dba Village Pointe Aesthetic Surgery 17617 BURKE STREET (402) 596-4000 FAX: (402) 596-4001 UNMC PHYSICIANS JANET BOND, ADMINISTRATOR ASC059 TJC OMAHA (DOUGLAS) - 68124 UROHSD, LLC dba Fresenius Medical Care-Nebraska Home Dialysi 2916 SOUTH 84TH STREET (402) 393-2865 FAX: (402) 397-0108 UROHSD, LLC SHIRLEY IRVIN, ADMINISTRATOR ESRD063 NONE HOME HOME PERITONEAL DIALYSIS
Page 23 of 24 PAPILLION (SARPY) - 68046 PAPILLION EYE SURGICAL CENTER ASC041 535 FORTUNE DRIVE, SUITE 200 (402) 934-9033 FAX: (402) 934-9506 PAPILLION EYE SURGICAL CENTER, INC SUSAN SEATON, ADMINISTRATOR c/o: PAPILLION EYE SURGICAL CENTER PO BOX 609, BELLEVUE NE 68005 SCOTTSBLUFF (SCOTTS BLUFF) - 69361 OREGON TRAIL EYE SURGERY CENTER, INC 329 WEST 40TH STREET (308) 635-3911 FAX: (308) 635-3130 OREGON TRAIL EYE SURGERY CENTER, INC BARBARA MILLER, ADMINISTRATOR ASC039 SCOTTSBLUFF (SCOTTS BLUFF) - 69361 SCOTTSBLUFF DIALYSIS CENTER 3812 AVENUE B (308) 630-0811 FAX: (308) 630-0814 RENAL TREATMENT CENTERS - WEST, INC APRIL CONN, ADMINISTRATOR ESRD017 HOME PERITONEAL DIALYSIS PERITONEAL DIALYSIS REUSE c/o: DAVITA, INC - ATTN REGINA COPELAND LICENSURE & CERTIFICATION, 5200 VIRGINIA WAY, BRENTWOOD TN SCOTTSBLUFF (SCOTTS BLUFF) - 69361 Western Sleep Medicine LLC 416 VALLEY VIEW DRIVE SUITE 400 (308) 633-3000 FAX: (308) 633-3001 WESTERN SLEEP MEDICINE, LLC MARK SCHULTZ, ADMINISTRATOR HC HC048 TECUMSEH (JOHNSON) - 68450 FAMILY HEALTH SERVICES, INC 509 BROADWAY STREET (402) 335-2988 FAX: (402) 335-3747 FAMILY HEALTH SERVICES, INC. SHARON RICKMAN, ADMINISTRATOR HC064 BRANCH/EXTENSION/OFFSITE: PERU STATE COLLEGE, WHEELER CNTR, PERU HEALTH CNTR - PE BRANCH/EXTENSION/OFFSITE: 829 W COURT STREET, SUITE 4 - BEATRICE BRANCH/EXTENSION/OFFSITE: C/O DOANE COLL-PERRY CAMPUS CNTR-1014 BOSWELL AVE - CRE BRANCH/EXTENSION/OFFSITE: 630 N COTNER, SUITE 204 - LINCOLN
Page 24 of 24 YORK (YORK) - 68467 YORK GENERAL DIALYSIS SERVICES ESRD027 2319 NORTH LINCOLN AVENUE (402) 363-6630 FAX: (402) 363-6632 YORK GENERAL HEALTH CARE SERVICES VALERIE FRIESEN, ADMINISTRATOR c/o: YORK GENERAL DIALYSIS SERVICES 2319 NORTH LINCOLN AVENUE, YORK NE 68467 Total Facilities: 109