NPIMap

Organization Active NPI

Todd Luedeke PC

  • Certified Registered Nurse Anesthetist
  • South Sioux City, NE
National Provider Identifier
1194374066
Registry record updated Sep 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
TODD LUEDEKE PC
Practice address
201 E 4TH St
South Sioux City, NE 68776-1706
Phone
(402) 369-4763
NPI assigned
Sep 4, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2019

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

Authorized official

Name
Todd Roger Luedeke, CRNANPI 1700832839
Title
President
Phone
(402) 369-4763

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
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

201 E 4TH St
South Sioux City, NE 68776-1706

Mailing address

85726 575TH Ave
Wayne, NE 68787-8032
Phone (402) 369-4763

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191014001008 NE Part B Supplier - Clinic/Group Practice 0244561868 Receives reassigned benefits from 5 practitioners
Practice locations: South Sioux City, NE; Wayne, NE

National Provider Directory

National Provider Directory

Locations

2730 Pierce St
Sioux City, IA 51104
Phone (712) 224-3380

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567555200000",
    "number": "1194374066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85726 575TH AVE",
            "city": "WAYNE",
            "state": "NE",
            "postal_code": "687878032",
            "telephone_number": "402-369-4763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E 4TH ST",
            "city": "SOUTH SIOUX CITY",
            "state": "NE",
            "postal_code": "687761706",
            "telephone_number": "402-369-4763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TODD LUEDEKE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-04",
        "last_updated": "2019-09-04",
        "status": "A",
        "authorized_official_last_name": "LUEDEKE",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "ROGER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-369-4763",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Sioux City, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2019; 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.

Verify at the official NPI Registry.