Provider Demographics
| NPI: | 1437184652 |
|---|---|
| Name: | THE PHYSICIAN NETWORK |
| Entity type: | Organization |
| Organization Name: | THE PHYSICIAN NETWORK |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | SYSTEM SENIOR VP |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | DAVID |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | PRITZA |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 402-343-4477 |
| Mailing Address - Street 1: | 2000 Q ST |
| Mailing Address - Street 2: | SUITE 500 |
| Mailing Address - City: | LINCOLN |
| Mailing Address - State: | NE |
| Mailing Address - Zip Code: | 68503-3609 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 402-421-0896 |
| Mailing Address - Fax: | 402-421-0945 |
| Practice Address - Street 1: | 7440 S 91ST ST |
| Practice Address - Street 2: | |
| Practice Address - City: | LINCOLN |
| Practice Address - State: | NE |
| Practice Address - Zip Code: | 68526-9797 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 402-421-0896 |
| Practice Address - Fax: | 402-421-0945 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-07-12 |
| Last Update Date: | 2023-09-25 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Single Specialty | |
| No | 207LC0200X | Allopathic & Osteopathic Physicians | Anesthesiology | Critical Care Medicine | Group - Single Specialty |
| No | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Single Specialty | |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Single Specialty | |
| No | 207RN0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | Group - Single Specialty |
| No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Single Specialty | |
| No | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | Group - Single Specialty | |
| No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Single Specialty | |
| No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Single Specialty |
| No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Single Specialty | |
| No | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | Group - Single Specialty | |
| No | 235500000X | Speech, Language and Hearing Service Providers | Specialist/Technologist | Group - Single Specialty | |
| No | 363AM0700X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | Group - Single Specialty |
| No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Single Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| NE | 10024988300 | Medicaid | |
| KS | 208317008 | Medicaid | |
| NE | 10024946900 | Medicaid | |
| NE | 10024991800 | Medicaid | |
| NE | 10025529000 | Medicaid | |
| NE | 10025323000 | Medicaid | |
| NE | =========33 | Medicaid | |
| NE | 10024946900 | Medicaid | |
| NE | 10024991800 | Medicaid | |
| NE | =========07 | Medicaid | |
| NE | =========16 | Medicaid | |
| NE | 10025529000 | Medicaid | |
| NE | =========10 | Medicaid | |
| KS | 208317008 | Medicaid | |
| NE | =========15 | Medicaid | |
| NE | 10025323000 | Medicaid | |
| NE | =========11 | Medicaid | |
| NE | =========17 | Medicaid | |
| NE | =========02 | Medicaid | |
| NE | 10024988300 | Medicaid | |
| NE | =========02 | Medicaid | |
| NE | NA1892 | Medicare PIN |
