Individual provider Active NPI

Paige Fairhead, MPAS, PA-C

  • Physician Assistant
  • Lincoln, NE
National Provider Identifier
1013446004
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2133 Issued in NE
Practice address
5055 A St Ste 200
Lincoln, NE 68510-4970
Phone
(402) 483-8630
NPI assigned
Jun 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2133 NE Primary

Addresses

Primary practice location

5055 A St Ste 200
Lincoln, NE 68510-4970

Mailing address

5055 A St Ste 200
Lincoln, NE 68510-4970
Phone (402) 483-8630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170623000082 NE Practitioner - Physician Assistant 1759659337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bryan Physician NetworkGroup PAC ID 7315915873, 236 clinicians

Practice addresses (Care Compare)

2300 S 16TH St
Bryan Medical Center
Lincoln, NE 68502-3704
Phone (402) 481-1111

5055 A St
Lincoln, NE 68510-4970

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2133NEMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Bryan Physician Network CurrentSince Jul 19, 2021 Accepting new patients

Locations

2222 S 16th St
Ste 400A
Lincoln, NE 68502
Phone (402) 475-8877

5055 A St
Ste 200
Lincoln, NE 68510
Phone (402) 483-8630

2300 S 16th St
Lincoln, NE 68502
Phone (402) 434-6042

555 S 70th St
Lincoln, NE 68510
Phone (402) 219-8000

Interoperability endpoints

  • Direct secure messaging: ppolicky87122@hisp.bryanhealth.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1013446004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5055 A ST STE 200",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685104970",
            "telephone_number": "402-483-8630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5055 A ST STE 200",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685104970",
            "telephone_number": "402-483-8630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRHEAD",
        "first_name": "PAIGE",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-05",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.