NPIMap

Organization Active NPI

State of Nebraska Dept of Admin Services

Doing business as Beatrice State Developmental Center

  • Intellectual Disabilities Intermediate Care Facility
  • Beatrice, NE
National Provider Identifier
1114085826
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
STATE OF NEBRASKA DEPT OF ADMIN SERVICES
Doing business as
Beatrice State Developmental Center
Practice address
3000 Lincoln
Beatrice, NE 68310-3319
Phone
(402) 223-6600
Fax
(402) 223-7589
NPI assigned
Dec 5, 2006
Last updated
Oct 20, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
NEBRASKA DEPT OF ADMIN SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Authorized official

Name
Corina Harrison
Title
Facility Administrator
Phone
(402) 223-6600

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X NU
Health Service Clinic/Center 261QH0100X 098247BE NE
State or Local Public Health Clinic/Center 261QP0905X NU
General Acute Care Hospital 282N00000X 320003 NE
Intellectual Disabilities Intermediate Care Facility 315P00000X NU Primary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X ICFMR03 NE

Addresses

Primary practice location

3000 Lincoln
Beatrice, NE 68310-3319

Mailing address

3000 Lincoln
Beatrice, NE 68310-3319
Phone (402) 223-6600

Other names 1

  • Beatrice State Developmental Center Doing business as

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
Part of
State of Nebraska Dept

Locations

3000 Lincoln St
Beatrice, NE 68310
Phone (402) 223-6600

1700 N Victory Rd
#16
Norfolk, NE 68701
Phone (402) 370-3400

15345 W Maple Rd
Omaha, NE 68116
Phone (402) 595-2180

1102 W 42nd St
Scottsbluff, NE 69361
Phone (308) 632-0324

Practitioners & affiliated clinicians

Practitioners 38

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 38

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1114085826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 LINCOLN",
            "city": "BEATRICE",
            "state": "NE",
            "postal_code": "683103319",
            "telephone_number": "402-223-6600",
            "fax_number": "402-223-7589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 LINCOLN",
            "city": "BEATRICE",
            "state": "NE",
            "postal_code": "683103319",
            "telephone_number": "402-223-6600",
            "fax_number": "402-223-7589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF NEBRASKA DEPT OF ADMIN SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEBRASKA DEPT OF ADMIN SERVICES",
        "enumeration_date": "2006-12-05",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "CORINA",
        "authorized_official_title_or_position": "FACILITY ADMINISTRATOR",
        "authorized_official_telephone_number": "402-223-6600"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NE",
            "license": "098247BE",
            "primary": false
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NE",
            "license": "320003",
            "primary": false
        },
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NE",
            "license": "ICFMR03",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beatrice State Developmental Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Beatrice State Developmental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beatrice, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; 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.