| |
923 Senior Circle Macy NE 68039-4018 | |
(402) 837-5381 | |
(402) 837-5303 |
Full Name | |
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Speciality | Clinic/Center |
Location | 923 Senior Circle, Macy, Nebraska |
Authorized Official Name and Position | Sarah Rowland (CEO) |
Authorized Official Contact | 4028375381 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 250 Macy NE 68039-0250 Ph: (402) 837-5381 | 923 Senior Circle Macy NE 68039-4018 Ph: (402) 837-5381 |
NPI Number | 1114922143 |
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Provider Enumeration Date | 06/16/2005 |
Last Update Date | 01/07/2025 |
Medicare PECOS PAC ID | 4981664406 |
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Medicare Enrollment ID | O20050309001036 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114922143 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (Nebraska) | Primary |
341600000X | Ambulance | HC042 (Nebraska) | Secondary |
Provider Name | Cordell E Harthoorn |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1174769301 PECOS PAC ID: 2466424718 Enrollment ID: I20040809000428 |
Provider Name | Steven A Westby |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1023106150 PECOS PAC ID: 6204842917 Enrollment ID: I20060303000334 |
Provider Name | Kham V Ung |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1205937554 PECOS PAC ID: 5193708451 Enrollment ID: I20100806000826 |
Provider Name | Rodney J Dean |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1528037082 PECOS PAC ID: 3870585813 Enrollment ID: I20120223000377 |
Provider Name | Brandon Ridder |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1851731459 PECOS PAC ID: 9032352257 Enrollment ID: I20130906000558 |
Provider Name | Linda L Kneebone |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1003027384 PECOS PAC ID: 6800964461 Enrollment ID: I20140610001923 |
Provider Name | Amanda L Larson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457745986 PECOS PAC ID: 2961720982 Enrollment ID: I20150422002297 |
Provider Name | Misty D Carlson |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1083662324 PECOS PAC ID: 5597031294 Enrollment ID: I20171025000534 |
Provider Name | Lisa A. Pape |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1578072351 PECOS PAC ID: 7810263225 Enrollment ID: I20180228000046 |
Provider Name | Trisha M Harms |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164078333 PECOS PAC ID: 5890024053 Enrollment ID: I20190912003057 |
Provider Name | John J Heffron |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1609828797 PECOS PAC ID: 9931270816 Enrollment ID: I20191205000531 |
Provider Name | Ashleen L Blackbird |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497356125 PECOS PAC ID: 8921410812 Enrollment ID: I20201217002076 |
Provider Name | Arvin Lopez Santos |
---|---|
Provider Type | Practitioner - Nephrology |
Provider Identifiers | NPI Number: 1336363324 PECOS PAC ID: 5395896328 Enrollment ID: I20220112000559 |
Provider Name | Cassidy Simons |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1144959644 PECOS PAC ID: 4789060070 Enrollment ID: I20221011001090 |
Provider Name | Timothy J Ernesti |
---|---|
Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1972827194 PECOS PAC ID: 3870969645 Enrollment ID: I20221019001252 |
Provider Name | Patrick K Chau |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1992766299 PECOS PAC ID: 0648283432 Enrollment ID: I20230915001631 |
Provider Name | Maurice Blackbird |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821861840 PECOS PAC ID: 8628428968 Enrollment ID: I20231228001180 |
Provider Name | Rory P Keys |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1225558562 PECOS PAC ID: 4587089628 Enrollment ID: I20240112002794 |
Provider Name | Marissa Lundeen |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356113625 PECOS PAC ID: 1951744234 Enrollment ID: I20240205001091 |
Provider Name | Juan P Munoz |
---|---|
Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1033507207 PECOS PAC ID: 3476878075 Enrollment ID: I20240328000289 |
Provider Name | Tammie A Jensen |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1548490089 PECOS PAC ID: 8123551652 Enrollment ID: I20241023000804 |
Provider Name | Faith M Jenkins |
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Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1073932745 PECOS PAC ID: 3971036336 Enrollment ID: I20241024001205 |