Kimberly Deanne Christner, M.D.
Individual provider Active NPI Pediatrics Physician · Elkhorn, NE
NPI 1114288370 · NPPES record last updated Aug 14, 2015
Key facts
- NPI
- 1114288370
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 28601 (NE)
- Practice address
- 18018 Burke Street
Elkhorn, NE 68022-4417 - Phone
- (402) 573-7337
- Fax
- (402) 614-2314
- NPI assigned
- Jun 5, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Pediatric Medicine
- Education
- Other, 2012
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
18018 Burke St
Elkhorn, NE 68022-4417
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260407000418 | NE | Practitioner - Pediatric Medicine | 3678048758 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28601 | NE | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Village Pointe Pediatrics, PC | Pediatrics | Past | Accepting new patients |
| Village Pointe Pediatrics, PC | Pediatrics | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 28601 | NE | Yes |
Addresses
Primary practice location
18018 Burke Street
Elkhorn, NE 68022-4417
Mailing address
PO Box 31582
Omaha, NE 68131
Phone (402) 573-7337
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2012018298 | Other | MO | CHILDREN'S MERCY HOSPITAL |
Other names
- Kimberly Deanne Shubert
Other providers in Elkhorn, NE
- Amoolya Chengalasetty
- Chimney Rock Psychological Health
- Ashley Choma
- Sowa Chowdhury
- Jeanne E Christensen
- Olivia Christner
- Tetiana Chudiuk
- Stacy M Cihunka
- City of Elk Horn
- Brenna Alyse Clark
All providers in Elkhorn, NE · Pediatrics Physician in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.