Christopher P Costa MD PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20028 Issued in NE

Legal business name

CHRISTOPHER P COSTA MD PC

Doing business as

Costa Family Practice

Practice address

514 9TH Street
Gothenburg, NE 69138-1917

Phone

(308) 537-2222

Fax

(308) 537-2960

NPI assigned

Nov 2, 2006

Last updated

Oct 16, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christopher P Costa, MDNPI 1588669832

Title

Owner

Phone

(308) 537-2222

Specialties & licenses 1

Addresses

Other names 1

• Costa Family Practice Doing business as

Locations

Practitioners 3

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.

• Christopher P. Costa, M.D.

  • Family Medicine Physician
  • Los Banos, CA
  • NPI 1588669832
  NPD (past) Authorized official
• Vaughan A Wenzel, PA-C

  • Physician Assistant
  • Papillion, NE
  • NPI 1053367979
  NPD (past)
• Lety Elizabeth Costa, MD

  • Internal Medicine Physician
  • Dos Palos, CA
  • NPI 1821188269

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1194803353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 9TH STREET",
            "city": "GOTHENBURG",
            "state": "NE",
            "postal_code": "691381917",
            "telephone_number": "308-537-2222",
            "fax_number": "308-537-2960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 9TH STREET",
            "city": "GOTHENBURG",
            "state": "NE",
            "postal_code": "691381917",
            "telephone_number": "308-537-2222",
            "fax_number": "308-537-2960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTOPHER P COSTA MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "COSTA",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "308-537-2222",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "20028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Costa Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Lou Block, RDN LMNT
• Melissa Anne Brill, APRN FAMILY NURSE PR
• Hunter Brimm
• Sue Britt
• Carol Shackleton, M.D., P.C.
• City of Gothenburg (Gothenburg Vol. Fire Dept.)
• Blaine Michael Cornelius, P.A.
• Craig D Bartruff M.D., P.C. (Gothenburg Medical Arts Rural Health Clinic)
• Craig D Bartruff, M.D., P.C. (Gothenburg Medical Arts Rural Health Clinic)
• John Alan Daup, OTR/L

• Family Medicine Physician in Gothenburg, NE
• Providers in Gothenburg, NE by specialty
• Family Medicine Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.