Provider Demographics
NPI:1700844495
Name:CENTRAL NEBRASKA IMAGING, LLC
Entity Type:Organization
Organization Name:CENTRAL NEBRASKA IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RADIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-397-7100
Mailing Address - Street 1:501 N 87TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-2881
Mailing Address - Country:US
Mailing Address - Phone:402-397-7100
Mailing Address - Fax:402-505-6949
Practice Address - Street 1:2714 2ND AVE
Practice Address - Street 2:SUITE B
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-4419
Practice Address - Country:US
Practice Address - Phone:308-237-2234
Practice Address - Fax:308-237-2255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025248800Medicaid
NE099669Medicare PIN
NEP00200028Medicare PIN