NPIMap

Organization Active NPI

State of Nebraska Dept of Admin Services

  • Psychiatric Hospital
  • Norfolk, NE
National Provider Identifier
1013004787
Registry record updated Oct 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
520003 Issued in NE
Legal business name
STATE OF NEBRASKA DEPT OF ADMIN SERVICES
Practice address
1700 N Victory Rd
Box 1209
Norfolk, NE 68701-6859
Phone
(402) 370-3400
NPI assigned
Oct 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. William Gibson
Title
Chief Executive Officer
Phone
(402) 370-3400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 520003 NE Primary

Addresses

Primary practice location

1700 N Victory Rd
Box 1209
Norfolk, NE 68701-6859

Mailing address

1700 N Victory Rd
P.O. Box 1209
Norfolk, NE 68701-6859
Phone (402) 370-3400

Other identifiers 1

IdentifierTypeStateIssuer
00142OtherBC/BS OF NEBRASKA

Other names 1

  • Norfolk Regional Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040331001011 NE Part B Supplier - Clinic/Group Practice 0648180828 Receives reassigned benefits from 28 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Beatrice, NE; Bellevue, NE; Kearney, NE; Lincoln, NE; Norfolk, NE; Scottsbluff, NE

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1700 N Victory Rd
#1209
Norfolk, NE 68701
Phone (402) 370-3400

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286841600000",
    "number": "1013004787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 N VICTORY RD",
            "address_2": "P.O. BOX 1209",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687016859",
            "telephone_number": "402-370-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N VICTORY RD",
            "address_2": "BOX 1209",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687016859",
            "telephone_number": "402-370-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF NEBRASKA DEPT OF ADMIN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2010-10-12",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "402-370-3400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "NE",
            "license": "520003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF NEBRASKA",
            "identifier": "00142",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Norfolk Regional Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Norfolk, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.