Active NPI
Connie S Micek, M.D.
- Family Medicine Physician
- Hartington, NE
National Provider Identifier
1215984695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20035
- Practice address
- 405 W Darlene St
Hartington, NE 68739-4806 - Phone
- (402) 254-3935
- Fax
- (402) 254-2393
- NPI assigned
- May 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20035 | NE | Primary |
Addresses
Primary practice location
405 W Darlene St
Hartington, NE 68739-4806
Mailing address
PO Box 937
Hartington, NE 68739-0937
Phone (402) 254-3935
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20035 | NE | MD | Family Medicine Physician |
Interoperability endpoints
- connie.micek@avera.sdhealthlink.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280361600000",
"number": "1215984695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 937",
"city": "HARTINGTON",
"state": "NE",
"postal_code": "687390937",
"telephone_number": "402-254-3935",
"fax_number": "402-254-2393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 W DARLENE ST",
"city": "HARTINGTON",
"state": "NE",
"postal_code": "687394806",
"telephone_number": "402-254-3935",
"fax_number": "402-254-2393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICEK",
"first_name": "CONNIE",
"middle_name": "S",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-30",
"last_updated": "2010-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NE",
"license": "20035",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hartington, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.