NEBRASKA CREDENTIALS VERIFICATION ORGANIZATION CLIENTS & AFFILIATES Entity Address Staff Email Phone Fax Recent Change Advanced Surgery Center 111 South 10th Street Stacey Hart [email protected] 402-345-1712 402-345-1864 Omaha, NE 68102 All Care Health Center 900 South 6th Street Anita Hall, Credentialing [email protected] 712-325-1990 x 227 712 - 256 - 4432 (formerly Co. Bluffs Community Co. Bluffs, IA 51501 Gina Klein [email protected] 712-256-6572 Health Center) Gerri Brunow,AR Mgr. 712-325-1990 x 224 Kenneth Burkhart, MD-Med.Dir Boys Town National Research 555 North 30th Street Rene Preston [email protected] 531-355-6501 402-498-6357 Hospital Omaha, NE 68131 Nickole Cullen [email protected] 531-355-6509 Erica Harrod (Nickole’s backup) [email protected] 531-355-6598 Charles Drew Health Center PO Box 111609 Shayla Pierce [email protected] 402-451-3553 or 402-453-1970 Omaha, NE 68111 402-457-1200 x 265 Children’s Hospital and Medical 8200 Dodge Street Sara Watson, Manager(billing & [email protected] 402-955-3775 402-955-3780 Staff Center Omaha, NE 68114-4113 Initial) [email protected] 402-955-3776 Tammy Villone (AHP) [email protected] 402-955-3779 Anna Hudson, CPCS (Reappt) Colonoscopy Center, Inc. 9850 Nicholas Street, #100 Jessica Quick [email protected] 402-392-6446 402-343-1177 (aka Colon & Rectal Surgery) Omaha, NE 68114 Marilyn Marr, Credentialing [email protected] [email protected] Community Medical Center 3307 Barada Street Randee Tisdel, Credentialing [email protected] 402-245-6587 402-245-6607 P.O. Box 399 Falls City, NE 68355 Douglas County Community 4102 Woolworth Ave Jessica Woodard [email protected] 402-444-7612 402-996-8171 Mental Health Center Omaha, NE 68105 Facial Surgery Institute, LLC 2727 S 144th St, Suite 235 Angie Zuroski [email protected] 402-330-8460 Omaha, NE 68144 Methodist Fremont Health 450 East 23rd Street Kiley Cordes [email protected] 402-727-3796 402-727-3656 (formerly Fremont Area Medical Fremont, NE 68025 Center ) Friend Community Healthcare 905 Second Street Shalene Shepard [email protected] 402-947-2541 x 122 402-947-2951 System Friend, NE 68359 Shelly Holman [email protected] George C. Grape Community 2959 US Hwy 275 Pamette Grable [email protected] 712-382-1515 x 264 712-382-2185 Hospital Hamburg, IA 51640 Halley Hunter [email protected] Halley x 409 712-382-2023 Heartland Center for 7308 South 142nd Street DeEtte Staebell, Admin [email protected] 402-717-4220 402-717-4231 Reproductive Medicine Omaha, NE 68138 Elizabeth (Marie) Payton, [email protected] 402-717-4234 402-717-4231 REVISED 4/2019 Page 1 of 5 NEBRASKA CREDENTIALS VERIFICATION ORGANIZATION CLIENTS & AFFILIATES Entity Address Staff Email Phone Fax Recent Change Credentialing Immanuel Pathways 1044 N 115th Street, Ste 500 Coleen Davis, Exec Admin Asst [email protected] 402-829-3204 Omaha, NE 68154 Jill Nyquist, VP Comm [email protected] resources [email protected] Traci Soliz Jennie Edmundson Memorial 933 E Pierce Street Lisa Joy [email protected] 712-396-7495 712-396-6288 Hospital Council Bluffs, IA 51503 Lincoln Digestive Health, LLC 4545 R Street #100 Kim Weatherly, Credentialing [email protected] 402-465-4545 402-465-9011 Lincoln, NE 68503 Lincoln Endoscopy Center 4545 R Street #101 Kim Weatherly, Credentialing [email protected] 402-465-3633 402-465-3621 (Gastroenterology Specialties, Lincoln, NE 68503 PC) Lincoln Orthopedic Center 6900 A Street Michelle Knapp, Credentialing [email protected] 402-436-2042 402-434-2690 (LOC) P.O. Box 6939 Barb Proescholdt [email protected] 402-436-2072 402-434-2691 Lincoln, NE 68506 Nick Anderson, HR [email protected] 402-436-2901 402-436-2929 Lincoln Surgery 1730 South 70th Street Jodi Earl, Credentialing Spec. [email protected] 402-484-2329 402-484-9086 Endoscopy Services Lincoln, NE 68506 Lincoln Surgical Hospital 1710 South 70th Street Jodi Earl, Credentialing Spec. [email protected] 402-484-2329 402-484-9086 Lincoln, NE 68506 Methodist Hospital 8303 Dodge Street Cindy Hamilton, Admin Dir. [email protected] 402-354-7843 402-354-4785 Phone Omaha, NE 68114 Kristi Dziatkowski (Initial) [email protected] 402-354-4038 (Meredith) Robin Lance (AHP Initial) [email protected] 402-354-4036 Meredith Burke (Reappt) [email protected] 402-354-4031 Susy Stransky (Init & Reap [email protected] 402-354-4037 support) Midwest Surgery Center 10784 “V” Street Tina Severson [email protected] 402-502-5599 402-991-6766 Omaha, NE 68127 [email protected] [email protected] *Just in Case* Midwest Surgical Hospital, LLC 7915 Farnam Drive Chuck Livingston, Manager [email protected] 402-399-1971 402-399-1939 Omaha, NE 68114 Cheri Spanjer, Credentialing [email protected] 402-399-1972 402-398-9253 Miller Orthopaedic Affiliates, PC One Edmundson Place #500 Lisa Moore, Health Info [email protected] 712-388-0155 712-323-3252 Council Bluffs, IA 51503 Specialist Miracle Hills Surgery Center 11819 Miracle Hills Dr #201 Anne Remm, RN [email protected] 402-884-2450 402-884-2455 Omaha, NE 68154 Nebraska Surgery Center 625 South 70th St. Deb Scott – Business Office [email protected] 402-484-6600 402-484-6610 Lincoln, NE 68510 Manager / Credentialing REVISED 4/2019 Page 2 of 5 NEBRASKA CREDENTIALS VERIFICATION ORGANIZATION CLIENTS & AFFILIATES Entity Address Staff Email Phone Fax Recent Change OrthoNebraska Hospital 2808 South 143rd Plaza Sonja Cannon [email protected] 402-609-1018 402-609-1020 (formerly Nebraska Orthopaedic Omaha, NE 68144 Hospital) Omaha Surgical Center 8051 West Center Road Carol Malone, Credentialing [email protected] 402-391-3333 402-391-8593 Omaha, NE 68124 Omega Surgery Center, LLC 11606 Nicholas Street #200 Kellie Johnson, Credentialing [email protected] 402-493-2020 402-493-8987 Omaha, NE 68154 Jeanne Longnecker One World Community Health 4920 South 30th Street #103 Phyllis Masek [email protected] 402-502-8846 402-401-6005 Center Omaha, NE 68107 Judy Vodicka [email protected] 402-502-8841 Oral Surgery Associates 13215 Birch Drive, Ste100 Laurie Bergholz [email protected] 402-390-0770 x 252 402-390-1074 Omaha, NE 68164 Outpatient Surgical Specialties 11704 W Center Rd, Ste 110 Leah Eppenbach [email protected] 402-691-1575 402-691-1599 Center, LLC Omaha, NE 68144 Pacific Surgery Center, LLC 10707 Pacific Street, Ste 100 Audrey Person, Credentialing [email protected] 402-933-1844 Omaha, NE 68164 Tim Fischer (All requests) [email protected] 402-399-7828 [email protected] 402-399-7817 402-980-4828 Physician’s Surgical Center 1500 S. 48th St. Erin Linn [email protected] Ste. 201 Terry Newby [email protected] Lincoln, NE 68506 Cheryl Church [email protected] Planned Parenthood of the P.O. Box 4557 Paula Farnen [email protected] 972-743-6746 469-291-5299 Heartland Des Moines, IA 50305-4557 515-235-0462 515-280-9525 R Choice Surgical Center, LLC 2900 Elk Lane Sofija Novakovic [email protected] 402-620-6650 402-620-6651 Fremont, NE 68025 South Omaha Surgical Center 3201 South 24th Street Emily Spooner [email protected] 402-504-4071 Omaha, NE 68108 m Southwest Lincoln Surgery 2222 S 16th Street Carla Lauenstein, RN, [email protected] 402-475-3100 402-475-3109 Center Tower B, STE 315 Administrator Lincoln, NE 68502 SurgiCenter of Norfolk 3400 W Norfolk Ave. Danielle Johnsen, Administrator [email protected] 402-379-5555 402-379-5564 Staff, email Norfolk, NE 68701 Katie Fryer (Danielle’s back up) [email protected] Urology Center PC 111 South 90th Street Rhonda Crosse [email protected] 402-397-5255 402-397-7591 Omaha, NE 68114 Pam Griswold [email protected] Laura Forehead [email protected] 402-397-9800 Julie Taylor (Reappt) [email protected] Urology Surgical Center 5500 Pine Lake Road Sheri Smith, Admin 402-489-8888 402-421-1945 REVISED 4/2019 Page 3 of 5 NEBRASKA CREDENTIALS VERIFICATION ORGANIZATION CLIENTS & AFFILIATES Entity Address Staff Email Phone Fax Recent Change Lincoln, NE 68516-3389 Lynn Chaulk, Credentialing [email protected] x 213 Valley County Health System 2707 L Street Lavon Coufal [email protected] 308 728-4347 308-728-7809 Ord, NE 68862 308-728-4218 REVISED 4/2019 Page 4 of 5 NEBRASKA CREDENTIALS VERIFICATION ORGANIZATION CLIENTS & AFFILIATES Nebraska Credentials Verification Organization (NCVO) Nebraska Credentials 7906 Davenport Street Reception Desk [email protected] 402-343-1108 402-343-0721 Verification Organization Omaha, NE 68114 Carol Wang, Executive Director [email protected] Ext 1000 Aaron Reeves, NCVO Manager [email protected] Ext 1004 Melissa Johnson, [email protected] Ext 1012 Implementation/Client Services Director INITIAL APPLICATIONS: Amy Henderson, Cred Specialist [email protected] Ext 1006 REAPPOINTMENTS: Diane Curran, Cred Specialist [email protected] Ext 1009 Gwen Martins, Cred Specialist [email protected] Ext 1008 Carol Beebe, Cred Specialist [email protected] Ext 1007 CREDENTIALING ASSOCIATE Dee Ann Davidson [email protected] Ext 1010 Medical Societies/Associations Metro Omaha Medical Society 7906 Davenport Street 402-393-1415 402-393-7391 Omaha, NE 68114 Carol Wang, Executive Director [email protected] Ext 1000 402-393-3216 www.omahamedical.com Frank Lastovica, Accts Payable/ [email protected] Ext 1001 Operations Asst Laura Polak, Membership [email protected] Ext 1002 Director Hailey Smith, Special Projects [email protected] Ext 1003 Lancaster County Medical 5625 O Street, Suite 3 Joan Anderson, Exec. Dir. [email protected] 402-483-4800 402-483-4802 Society Lincoln, NE 68510 Marilyn Keller [email protected] Nebraska Medical Association 233 S 13th Street #1512 Amy Reynoldson, Exec. VP [email protected] 402-474-4472 402-474-2198 Lincoln, NE 68508 800-684-9380 REVISED 4/2019 Page 5 of 5 .