Jefferson Community Health Center Inc
Organization Active NPI Rural Health Clinic/Center · Plymouth, NE
NPI 1215445994 · NPPES record last updated Jun 24, 2019
Key facts
- NPI
- 1215445994
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- JEFFERSON COMMUNITY HEALTH CENTER INC
- Practice address
- 316 N Madison Ave
Ste 200
Plymouth, NE 68424-4110 - Phone
- (402) 729-6888
- NPI assigned
- Jan 17, 2018
- Organization subpart
- Yes
- Parent organization (as reported)
- JEFFERSON COMMUNITY HEALTH CENTER INC
Authorized official
- Name
- Chad Jurgens
- Title
- Ceo
- Phone
- (402) 729-3351
Other NPIs on the same Medicare enrollment 1
Practitioners 29
-
Kirisha N Afuh, APRN
-
Eric J. Avery, M.D.
-
Richard A Blum, PA-C
-
Matthew Gatlin, PA-C
-
Jacqueline Hanson, D.O.
-
Abby N Hanzlicek, M.D.
-
Larissa L Hoffman, APRN
-
Quinton S Kelly, M.D.
-
Megan M Knutson, APRN
-
Jeffrey T Marple, M.D.
-
J Paul Meyer, MD
-
Jaime Jo Pieper, DO
-
Rahul S Razdan, M.D.
-
Matthew Shupe, D.O.
-
Rebecca Anne Stroklund, D.O.
-
Todd W. Stuckey, M.D.
-
Nicole J Topliff, ARNP
-
Brett Wergin, MD
-
James Bruce White II, FNP
-
Keegan J Williams, APRN
-
Kensly N Williams, PA-C
-
Jonathan Wood, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160506001438 | NE | Part B Supplier - Clinic/Group Practice | 2668574542 |
Receives reassigned benefits from 33 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Fairbury, NE; Lincoln, NE |
National Provider Directory
- Part of
- Jefferson Co Mem Hosp Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
316 N Madison Ave
Ste 200
Plymouth, NE 68424-4110
Mailing address
PO Box 277
Fairbury, NE 68352-0277
Phone (402) 729-3351
Other names
- Jefferson Community Health & Life Plymouth Clinic
- Plymouth Clinic
- The Plymouth Clinic
Other providers in Plymouth, NE
- Julie Ann Glover
- Symantha Lynn Janzen
- Plymouth Amb Rural Fire
- Plymouth Rural Fire Protection District No. 5
- Jennifer Washburn
All providers in Plymouth, NE · Rural Health Clinic/Center in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.