The Family Doc, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

THE FAMILY DOC, LLC

Practice address

2211 Capehart Rd Ste 103
Bellevue, NE 68123-2121

Phone

(402) 933-4111

Fax

(402) 934-4111

NPI assigned

Jul 30, 2009

Last updated

Jul 30, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kelly DG Collins, MDNPI 1972555258

Title

Physician

Phone

(402) 933-4111

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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.

• Kelly Denene Gonzales Collins, MD

  • Family Medicine Physician
  • Bellevue, NE
  • NPI 1972555258
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248912000000",
    "number": "1073744694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 CAPEHART RD STE 103",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "681232121",
            "telephone_number": "402-933-4111",
            "fax_number": "402-934-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 CAPEHART RD STE 103",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "681232121",
            "telephone_number": "402-933-4111",
            "fax_number": "402-934-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FAMILY DOC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-30",
        "last_updated": "2009-07-30",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "DG",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "402-933-4111",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas G Thayer
• Grace Thayer
• Lillian Thayer
• The Asthma & Allergy Center PC
• The Dizzy Doctor
• The Greater Works Networks Inc
• The Nebraska Medical Center
• Joseph Thibault
• Joann Thielen
• Sheri Marie Thiessen

• Family Medicine Physician in Bellevue, NE
• Providers in Bellevue, NE by specialty
• Family Medicine Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.