Provider Demographics
NPI:1518076884
Name:MCCANN, RHONDEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:RHONDEL
Middle Name:J
Last Name:MCCANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 6753
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-0753
Mailing Address - Country:US
Mailing Address - Phone:402-488-3766
Mailing Address - Fax:402-483-2152
Practice Address - Street 1:2300 S 16TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-3704
Practice Address - Country:US
Practice Address - Phone:402-488-3766
Practice Address - Fax:402-483-2152
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NENE22757208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE2300173OtherUNITED HEALTH CARE
NE577106OtherIOWA MEDICAID
NE03603OtherBLUE CROSS BLUE SHIELD
NE209366806OtherMISSOURI MEDICAID
NE7709850OtherSOUTH DAKOTA MEDICAID
NE243230OtherMIDLANDS CHOICE
NE200336140AOtherKANSAS MEDICAID
NE2300173OtherAMERICHOICE
NE270890OtherCOVENTRY OF NEBRASKA
NEP00155509OtherMEDICARE RAILROAD
NE243230OtherMIDLANDS CHOICE
NE277592Medicare ID - Type Unspecified