NPIMap

Organization Active NPI

Diabetes and Wellness Clinic LLC

  • Primary Care Clinic/Center
  • Norfolk, NE
National Provider Identifier
1225366388
Registry record updated Jan 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
110697 Issued in NE
Legal business name
DIABETES AND WELLNESS CLINIC LLC
Practice address
809 1/2 S 13TH St
Norfolk, NE 68701-5753
Phone
(402) 379-9600
Fax
(402) 379-9601
NPI assigned
Dec 1, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2010

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

Authorized official

Name
Michelle D Brtek Zwiener, APRNNPI 1144299041
Title
Owner/Diabetes Nurse Practitioner
Phone
(402) 379-9600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 110697 NE Primary

Addresses

Primary practice location

809 1/2 S 13TH St
Norfolk, NE 68701-5753

Mailing address

809 1/2 S 13TH St
Norfolk, NE 68701-5753
Phone (402) 379-9600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100104000587 NE Part B Supplier - Clinic/Group Practice 9638210305 Receives reassigned benefits from 3 practitioners
Practice locations: Atkinson, NE; Norfolk, NE

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
28D2002359Diabetes and Wellness Clinic LLC809 1/2 South 13TH Street, Norfolk, NE 68701Certificate of waiverJan 13, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1259625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262563200000",
    "number": "1225366388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 1/2 S 13TH ST",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687015753",
            "telephone_number": "402-379-9600",
            "fax_number": "402-379-9601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 1/2 S 13TH ST",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687015753",
            "telephone_number": "402-379-9600",
            "fax_number": "402-379-9601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETES AND WELLNESS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-01",
        "last_updated": "2010-01-04",
        "status": "A",
        "authorized_official_last_name": "BRTEK ZWIENER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/DIABETES NURSE PRACTITIONER",
        "authorized_official_telephone_number": "402-379-9600",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NE",
            "license": "110697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2010; 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.