Active NPI
Minuteclinic Diagnostic of Nebraska, LLC
- Family Nurse Practitioner
- Lincoln, NE
National Provider Identifier
1124449533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Legal business name
- MINUTECLINIC DIAGNOSTIC OF NEBRASKA, LLC
- Practice address
- 5566 S 56TH St
Lincoln, NE 68516-1834 - Phone
- (866) 389-2727
- Fax
- (401) 216-3549
- NPI assigned
- Jan 2, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Deborah Pincince
- Title
- Administrator
- Phone
- (401) 770-3813
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
5566 S 56TH St
Lincoln, NE 68516-1834
Mailing address
1 CVS Dr
Credentialing PO Box 772-MC 2295
Woonsocket, RI 02895-6146
Phone (866) 389-2727
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140804000925 | NE | Part B Supplier - Clinic/Group Practice | 6709003411 |
Receives reassigned benefits from 38 practitioners Practice locations: La Vista, NE; Lincoln, NE; Omaha, NE |
National Provider Directory
National Provider DirectoryLocations
5566 S 56th St
Lincoln, NE 68516
Phone (402) 423-3839
Practitioners & affiliated clinicians
Practitioners 38
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- La Vista, NE
- NPI 1962836023
Family, NE
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1388620800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1648512000000",
"number": "1124449533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DR",
"address_2": "CREDENTIALING PO BOX 772-MC 2295",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "028956146",
"telephone_number": "866-389-2727",
"fax_number": "401-216-3549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5566 S 56TH ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685161834",
"telephone_number": "866-389-2727",
"fax_number": "401-216-3549"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MINUTECLINIC DIAGNOSTIC OF NEBRASKA, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-01-02",
"last_updated": "2022-03-29",
"certification_date": "2022-03-29",
"status": "A",
"authorized_official_last_name": "PINCINCE",
"authorized_official_first_name": "DEBORAH",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "401-770-3813"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.