Provider Demographics
| NPI: | 1134355332 |
|---|---|
| Name: | NORTH PLATTE NEBRASKA HOSPITAL CORPORATION |
| Entity type: | Organization |
| Organization Name: | NORTH PLATTE NEBRASKA HOSPITAL CORPORATION |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CFO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | SUMMER |
| Authorized Official - Middle Name: | D |
| Authorized Official - Last Name: | OWEN |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 308-568-7496 |
| Mailing Address - Street 1: | 601 W LEOTA ST |
| Mailing Address - Street 2: | |
| Mailing Address - City: | NORTH PLATTE |
| Mailing Address - State: | NE |
| Mailing Address - Zip Code: | 69101-6598 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 308-568-7496 |
| Mailing Address - Fax: | 308-535-3410 |
| Practice Address - Street 1: | 601 W LEOTA ST |
| Practice Address - Street 2: | |
| Practice Address - City: | NORTH PLATTE |
| Practice Address - State: | NE |
| Practice Address - Zip Code: | 69101-6598 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 308-568-7496 |
| Practice Address - Fax: | 308-535-3410 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | Yes |
| Parent Organization LBN: | NORTH PLATTE NEBRASKA HOSPITAL CORPORATION |
| Parent Organization TIN: | <UNAVAIL> |
| Enumeration Date: | 2009-06-03 |
| Last Update Date: | 2024-10-18 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207RX0202X | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology | Group - Multi-Specialty |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
| No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Multi-Specialty |
| No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
| No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
| No | 207RI0011X | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | Group - Multi-Specialty |
| No | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Multi-Specialty |
| No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
| No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
| No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
| No | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
| No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
| No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| NE | 10026179800 | Medicaid | |
| NE | 10025379100 | Medicaid | |
| CN8971 | Other | RAILROAD MEDICARE | |
| CN8971 | Other | RAILROAD MEDICARE | |
| NE | 10025379100 | Medicaid | |
| NE | =========11 | Medicaid |
