Provider Demographics
NPI:1003858473
Name:HASTINGS ORTHOPAEDICS & SPORTS MEDICINE SPECIALISTS PC
Entity Type:Organization
Organization Name:HASTINGS ORTHOPAEDICS & SPORTS MEDICINE SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CHINGREN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-462-2139
Mailing Address - Street 1:2207 OSBORNE DR W
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-9112
Mailing Address - Country:US
Mailing Address - Phone:402-462-2139
Mailing Address - Fax:402-462-2381
Practice Address - Street 1:2207 OSBORNE DR W
Practice Address - Street 2:SUITE 100
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-9112
Practice Address - Country:US
Practice Address - Phone:402-462-2139
Practice Address - Fax:402-462-2381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1820OtherBLUE CROSS/BLUE SHIELD
NE1820OtherBLUE CROSS/BLUE SHIELD
NE98856Medicare ID - Type Unspecified