NPIMap

Organization Active NPI

Bertrand Health Clinic, LLC

  • Family Nurse Practitioner
  • Bertrand, NE
National Provider Identifier
1174824049
Registry record updated Nov 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
110285 Issued in NE
Legal business name
BERTRAND HEALTH CLINIC, LLC
Practice address
402 Minor Ave
Bertrand, NE 68927-1234
Phone
(308) 472-1472
Fax
(308) 472-1471
NPI assigned
Nov 9, 2010
Last updated
Nov 24, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2010

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

Authorized official

Name
Ruby Joan Houck, APRN
Title
Owner Operator
Phone
(308) 472-1472

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 110285 NE Primary

Addresses

Primary practice location

402 Minor Ave
Bertrand, NE 68927-1234

Mailing address

402 Minor Ave
PO Box 444
Bertrand, NE 68927-1234
Phone (308) 472-1472

Other identifiers 1

IdentifierTypeStateIssuer
38615OtherNEBLU CROSS AND BLUE SHIELD

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290556800000",
    "number": "1174824049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 MINOR AVE",
            "address_2": "PO BOX 444",
            "city": "BERTRAND",
            "state": "NE",
            "postal_code": "689271234",
            "telephone_number": "308-472-1472",
            "fax_number": "308-472-1471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 MINOR AVE",
            "city": "BERTRAND",
            "state": "NE",
            "postal_code": "689271234",
            "telephone_number": "308-472-1472",
            "fax_number": "308-472-1471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERTRAND HEALTH CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-09",
        "last_updated": "2010-11-24",
        "status": "A",
        "authorized_official_last_name": "HOUCK",
        "authorized_official_first_name": "RUBY",
        "authorized_official_middle_name": "JOAN",
        "authorized_official_title_or_position": "OWNER OPERATOR",
        "authorized_official_telephone_number": "308-472-1472",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "110285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLU CROSS AND BLUE SHIELD",
            "identifier": "38615",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bertrand, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2010; 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.