Coddington Medical Family Practice LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

17443 Issued in NE

Legal business name

CODDINGTON MEDICAL FAMILY PRACTICE LLC

Practice address

1336 West a Street, Suite a
Lincoln, NE 68522

Phone

(402) 742-2502

NPI assigned

Oct 30, 2013

Organization subpart

No

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

Authorized official

Name

Timothy J Sullivan, M.D.NPI 1376524611

Title

President

Phone

(402) 742-2502

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

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

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10067211

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy Joseph Sullivan, M.D.

  • Family Medicine Physician
  • Lincoln, NE
  • NPI 1376524611
  Medicare reassignment Care Compare group Authorized official
• Delia Marie Gilbertsen, PA-C

  • General Practice Physician
  • Lincoln, NE
  • NPI 1447712393
  Medicare reassignment Care Compare group
• Kyle T Ginnaty, PA

  • Physician Assistant
  • Omaha, NE
  • NPI 1194451377
  Medicare reassignment Care Compare group
• Sally Homan, PA

  • Physician Assistant
  • Lincoln, NE
  • NPI 1629759113
  Medicare reassignment Care Compare group
• Bridget Dawn Green, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Lincoln, NE
  • NPI 1992905467
  Medicare reassignment
• Kathryn Anna Palu, PA

  • Physician Assistant
  • Lincoln, NE
  • NPI 1477147494
  Medicare reassignment

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

{
    "created_epoch": "1383091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1205264231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7711 W WALIN LN",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685329200",
            "telephone_number": "402-742-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1336 WEST A STREET, SUITE A",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "68522",
            "telephone_number": "402-742-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CODDINGTON MEDICAL FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-30",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-742-2502",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NE",
            "license": "17443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Journey Cochrane
• Taila A Cochren
• Emmalee Cockerill
• Katrina Coco
• Coddington Dental
• Coddington Physical Therapy, LLC
• Cara Elizabeth Coder
• Joanna Adeline Coe, CRNA
• Andrew D. Coen, MD
• Carolyn Coffey, LIMHP

• Primary Care Clinic/Center in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Primary Care Clinic/Center in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.