Provider Demographics
NPI:1831283951
Name:GREAT PLAINS FOOT AND ANKLE SPECIALISTS PC
Entity Type:Organization
Organization Name:GREAT PLAINS FOOT AND ANKLE SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:C
Authorized Official - Last Name:MATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-532-3600
Mailing Address - Street 1:815 S MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-5282
Mailing Address - Country:US
Mailing Address - Phone:308-532-3600
Mailing Address - Fax:308-532-6288
Practice Address - Street 1:815 S MAPLE ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-5282
Practice Address - Country:US
Practice Address - Phone:308-532-3600
Practice Address - Fax:308-532-6288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE235213E00000X
NE223213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NECS9720OtherRAILROAD MEDICARE GROUP
NECS9720OtherRAILROAD MEDICARE GROUP
NECS9720OtherRAILROAD MEDICARE GROUP
NE=========13Medicaid
NEU20697Medicare UPIN
NE098480Medicare ID - Type UnspecifiedGROUP
NE6385940001Medicare NSC
NE267174Medicare ID - Type UnspecifiedDR SCHAFER