NPIMap

Organization Active NPI

Plum Creek Medical Group, P.C.

  • Family Medicine Physician
  • Lexington, NE
National Provider Identifier
1104868496
Registry record updated Feb 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PLUM CREEK MEDICAL GROUP, P.C.
Practice address
1103 Buffalo BND
Lexington, NE 68850-1528
Phone
(308) 324-6386
Fax
(308) 324-6913
NPI assigned
Jun 12, 2006
Last updated
Feb 12, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2014

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

Authorized official

Name
James Naeve
Title
Administrator
Phone
(308) 324-6386

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1103 Buffalo BND
Lexington, NE 68850-1528

Mailing address

1103 Buffalo BND
PO Box 797
Lexington, NE 68850-1528
Phone (308) 324-6386

Other identifiers 1

IdentifierTypeStateIssuer
01950OtherNEBLUE CROSS/BLUE SHIELD NE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071103000049 NE Part B Supplier - Clinic/Group Practice 7618064833 Receives reassigned benefits from 11 practitioners
Practice locations: Lexington, NE

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
28D0455988Plum Creek Medical Group1103 Buffalo BND PO Box 797, Lexington, NE 68850Certificate of waiverFeb 28, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392163200000",
    "number": "1104868496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 BUFFALO BND",
            "address_2": "PO BOX 797",
            "city": "LEXINGTON",
            "state": "NE",
            "postal_code": "688501528",
            "telephone_number": "308-324-6386",
            "fax_number": "308-324-6913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 BUFFALO BND",
            "city": "LEXINGTON",
            "state": "NE",
            "postal_code": "688501528",
            "telephone_number": "308-324-6386",
            "fax_number": "308-324-6913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLUM CREEK MEDICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2014-02-12",
        "status": "A",
        "authorized_official_last_name": "NAEVE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "308-324-6386"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD NE",
            "identifier": "01950",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2014; 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.