Provider Demographics
NPI:1780039354
Name:NEBRASKA PAIN MANAGEMENT PHYSICIANS PC
Entity Type:Organization
Organization Name:NEBRASKA PAIN MANAGEMENT PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LAMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-884-3971
Mailing Address - Street 1:2501 LAKERIDGE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-2558
Mailing Address - Country:US
Mailing Address - Phone:402-316-4027
Mailing Address - Fax:402-884-8751
Practice Address - Street 1:2501 LAKERIDGE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-2558
Practice Address - Country:US
Practice Address - Phone:402-316-4027
Practice Address - Fax:402-884-8751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-02
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE21621207L00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEH86650Medicare UPIN