NPIMap

Organization Active NPI

State of Nebraska Dept of Admin Services

  • Health Service Clinic/Center
  • Lincoln, NE
National Provider Identifier
1063253714
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
STATE OF NEBRASKA DEPT OF ADMIN SERVICES
Practice address
3218 W Van Dorn St
Lincoln, NE 68522-9278
Phone
(402) 479-6331
Fax
(402) 479-6100
NPI assigned
Jun 5, 2024
Organization subpart
Yes
Parent organization
STATE OF NEBRASKA DEPT OF ADMIN SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Authorized official

Name
Cassandra Jane Putnam
Title
Health Care Administrator
Phone
(402) 479-5630

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

3218 W Van Dorn St
Lincoln, NE 68522-9278

Mailing address

3218 W Van Dorn St
Lincoln, NE 68522-9278
Phone (402) 479-6331

Other names 1

  • NDCS Reception and Treatment Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Tran Paul MD27 organizations share this tax ID, including this one
Part of
Tran Paul MD

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Locations

3218 W Van Dorn St
Lincoln, NE 68522
Phone (402) 479-4091

NPI Registry JSON

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717545600000",
    "number": "1063253714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3218 W VAN DORN ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685229278",
            "telephone_number": "402-479-6331",
            "fax_number": "402-479-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3218 W VAN DORN ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685229278",
            "telephone_number": "402-479-6331",
            "fax_number": "402-479-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF NEBRASKA DEPT OF ADMIN SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF NEBRASKA DEPT OF ADMIN SERVICES",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A",
        "authorized_official_last_name": "PUTNAM",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "HEALTH CARE ADMINISTRATOR",
        "authorized_official_telephone_number": "402-479-5630"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NDCS Reception and Treatment Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.