| Avera Medical Group Niobrara | |
|
25410 Park Ave Apt E Niobrara NE 68760-7044 | |
| (402) 857-3398 | |
| (402) 857-3315 |
| Full Name | Avera Medical Group Niobrara |
|---|---|
| Speciality | Clinic/Center |
| Location | 25410 Park Ave Apt E, Niobrara, Nebraska |
| Authorized Official Name and Position | Douglas Ekeren (CEO/PRESIDENT) |
| Authorized Official Contact | 6056688321 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avera Medical Group Niobrara Po Box 86370 Sioux Falls SD 57118-6370 Ph: (605) 322-4933 | Avera Medical Group Niobrara 25410 Park Ave Apt E Niobrara NE 68760-7044 Ph: (402) 857-3398 |
| NPI Number | 1730448671 |
|---|---|
| Provider Enumeration Date | 05/13/2012 |
| Last Update Date | 04/24/2023 |
| Medicare PECOS PAC ID | 6103729066 |
|---|---|
| Medicare Enrollment ID | O20160818002275 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730448671 | NPI | - | NPPES |
| NA1399 | Other | NE | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Santee Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 110 S Visiting Eagle St, Niobrara, NE 68760 Phone: 402-857-2300 Fax: 402-857-2416 | |
Santee Sioux Tribe Of Nebraska Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 S Visiting Eagle St, Niobrara, NE 68760 Phone: 402-857-2300 Fax: 402-857-2910 | |
Avera Medical Group Niobrara Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 25410 Park Ave, Apartment E, Niobrara, NE 68760 Phone: 402-857-3398 Fax: 402-857-3315 | |
Santee Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 S Visiting Eagle St, Niobrara, NE 68760 Phone: 402-857-2300 Fax: 402-857-2315 |