Provider Demographics
NPI:1568401982
Name:PLATTE RIVER REHAB MEDICINE P.C.
Entity Type:Organization
Organization Name:PLATTE RIVER REHAB MEDICINE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:ERICA
Authorized Official - Last Name:SORENSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:308-534-9100
Mailing Address - Street 1:321 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-4032
Mailing Address - Country:US
Mailing Address - Phone:308-534-9100
Mailing Address - Fax:308-534-9112
Practice Address - Street 1:321 E 3RD ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-4032
Practice Address - Country:US
Practice Address - Phone:308-534-9100
Practice Address - Fax:308-534-9112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE23650208100000X
261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025398700Medicaid
NEDF0145OtherRAILROAD MEDICARE
NEDF0145OtherRAILROAD MEDICARE