NPIMap

Organization Active NPI

Broken Bow Public Schools County of Custer School District 25

  • Clinic/Center
  • Broken Bow, NE
National Provider Identifier
1114678182
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
BROKEN BOW PUBLIC SCHOOLS COUNTY OF CUSTER SCHOOL DISTRICT 25
Practice address
323 N 7TH Ave
Broken Bow, NE 68822-1718
Phone
(308) 872-6821
Fax
(308) 872-2751
NPI assigned
Jan 12, 2022
Last updated
Jan 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Authorized official

Name
Mrs. Debra E Mayor-Gaston
Title
Sped Administrative Assistant
Phone
(308) 872-6821

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

323 N 7TH Ave
Broken Bow, NE 68822-1718

Mailing address

323 N 7TH Ave
Broken Bow, NE 68822-1718
Phone (308) 872-6821

Other practice location 1

1135 N H St
Broken Bow, NE 68822-1262
Phone (308) 872-2982 ext. 505

National Provider Directory

National Provider Directory

Locations

1135 N H St
Broken Bow, NE 68822
Phone (308) 872-2982

323 N 7th Ave
Broken Bow, NE 68822
Phone (308) 872-2475

Practitioners & affiliated clinicians

Practitioners 52

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 52

NPI Registry JSON

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

{
    "created_epoch": "1641945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641945600000",
    "number": "1114678182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 N 7TH AVE",
            "city": "BROKEN BOW",
            "state": "NE",
            "postal_code": "688221718",
            "telephone_number": "308-872-6821",
            "fax_number": "308-872-2751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 N 7TH AVE",
            "city": "BROKEN BOW",
            "state": "NE",
            "postal_code": "688221718",
            "telephone_number": "308-872-6821",
            "fax_number": "308-872-2751"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1135 N H St",
            "address_purpose": "LOCATION",
            "city": "Broken Bow",
            "state": "NE",
            "postal_code": "688221262",
            "country_code": "US",
            "telephone_number": "308-872-2982 x505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BROKEN BOW PUBLIC SCHOOLS COUNTY OF CUSTER SCHOOL DISTRICT 25",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-12",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-11",
        "status": "A",
        "authorized_official_last_name": "MAYOR-GASTON",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "SPED ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "308-872-6821",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Bow, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; 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.