NPIMap

Organization Active NPI

Midtown Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Norfolk, NE
National Provider Identifier
1194598995
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MIDTOWN HEALTH CENTER, INC.
Practice address
1900 Vicki LN
Norfolk, NE 68701-4558
Phone
(402) 371-8000
Fax
(402) 371-0971
NPI assigned
Nov 2, 2023
Organization subpart
Yes
Parent organization
MIDTOWN HEALTH CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Authorized official

Name
Melodee J Drenkow
Title
Quality Management Director
Phone
(402) 841-1594

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1900 Vicki LN
Norfolk, NE 68701-4558

Mailing address

302 W Phillip Ave
Norfolk, NE 68701-5248
Phone (402) 371-8000

Other names 1

  • Midtown BHS Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040519001227 NE Part B Supplier - Clinic/Group Practice 9133110182 Receives reassigned benefits from 17 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Norfolk, NE; Madison, NE
O20240408001090 NE Part A Provider - Federally Qualified Health Center (FQHC) 9133110182 Practice locations: Norfolk, NE

Federally qualified health center certification: CCN D01000

Legal name
MIDTOWN HEALTH CENTER INC
Doing business as
MIDTOWN-BHS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 5, 2024
Last certification
Apr 5, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 13, 2014 in NE
Enrollment address
1900 Vicki LN
Norfolk, NE 68701-4558

Other NPIs with the same Medicare PAC ID 16

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 16

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
28D2297053Midtown-BHS1900 Vicki LN, Norfolk, NE 68701Certificate of waiverJan 9, 2028

National Provider Directory

National Provider Directory
Tax ID family
Midtown Health Center Inc19 organizations share this tax ID, including this one
Part of
Midtown Health Center Inc

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

302 W Phillip Ave
Norfolk, NE 68701
Phone (402) 370-1064

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Betty Froehlich Individual OtherVice-Chairman Jan 1, 2004
Gretchen Forsell Individual OtherBoard Member Jan 1, 2004
Mary Luhr Individual OtherBoard Member Jan 1, 2018
Brenda Jones Individual OtherBoard Secretary Jan 1, 2008
Lance Morrow Individual OtherBoard Treasurer Jan 1, 2016
Susie Lutz Individual OtherBoard Chair Jan 1, 2015
Karen Weidner Individual OtherBoard Member Jan 1, 2001
Kathy Nordby Individual Corporate OfficerChief Executive Officer Oct 1, 2011 100%
Operational/Managerial ControlChief Executive Officer Oct 1, 2011 100%
Melodee Drenkow Individual Corporate DirectorQuality Management Director Sep 1, 2021

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Midtown Health Center IncNorfolk, NE, CCN 281812 Federally qualified health center Operational/Managerial Control Aug 1, 2008
Midtown Health Center - MadisonMadison, NE, CCN 281813 Federally qualified health center Operational/Managerial Control Apr 6, 2009

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1698883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700006400000",
    "number": "1194598995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 W PHILLIP AVE",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687015248",
            "telephone_number": "402-371-8000",
            "fax_number": "402-371-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 VICKI LN",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687014558",
            "telephone_number": "402-371-8000",
            "fax_number": "402-371-0971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDTOWN HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIDTOWN HEALTH CENTER, INC.",
        "enumeration_date": "2023-11-02",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A",
        "authorized_official_last_name": "DRENKOW",
        "authorized_official_first_name": "MELODEE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "QUALITY MANAGEMENT DIRECTOR",
        "authorized_official_telephone_number": "402-841-1594"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midtown BHS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norfolk, NE

Sources for this page

Verify at the official NPI Registry.