NPIMap

Organization Active NPI

South Lincoln Family Physicians, PC

  • Family Medicine Physician
  • Lincoln, NE
National Provider Identifier
1124548540
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SOUTH LINCOLN FAMILY PHYSICIANS, PC
Practice address
3201 Pioneers Blvd Ste 304
Lincoln, NE 68502-5963
Phone
(402) 483-2987
NPI assigned
Jun 27, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Nathan Denell, DONPI 1124119482
Title
Secretary
Phone
(402) 483-2987

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

3201 Pioneers Blvd Ste 304
Lincoln, NE 68502-5963

Mailing address

3201 Pioneers Blvd Ste 304
Lincoln, NE 68502-5963
Phone (402) 483-2987

Other practice location 1

4130 Pioneer Woods Dr Ste 2
Lincoln, NE 68506-7552
Phone (402) 483-2987

Other identifiers 1

IdentifierTypeStateIssuer
1144337643OtherQUALITY INCENTIVE

National Provider Directory

National Provider Directory

Locations

3201 Pioneers Blvd
Ste 304
Lincoln, NE 68502
Phone (402) 483-2987

4130 Pioneer Woods Dr
Ste 2
Lincoln, NE 68506
Phone (402) 483-2987

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1124548540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 PIONEERS BLVD STE 304",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685025963",
            "telephone_number": "402-483-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 PIONEERS BLVD STE 304",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685025963",
            "telephone_number": "402-483-2987"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4130 Pioneer Woods Dr Ste 2",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "NE",
            "postal_code": "685067552",
            "country_code": "US",
            "telephone_number": "402-483-2987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTH LINCOLN FAMILY PHYSICIANS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-27",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DENELL",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "402-483-2987",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALITY INCENTIVE",
            "identifier": "1144337643",
            "state": null
        }
    ],
    "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 Jul 21, 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.