NPIMap

Organization Active NPI

Ear, Nose, Throat & Sinus Clinic, LLC

  • Otolaryngology Physician
  • North Platte, NE
National Provider Identifier
1255607891
Registry record updated Mar 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
EAR, NOSE, THROAT & SINUS CLINIC, LLC
Practice address
106 E C St
North Platte, NE 69101-5411
Phone
(308) 532-6165
Fax
(308) 532-7464
NPI assigned
Mar 28, 2012
Last updated
Mar 28, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2012

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

Authorized official

Name
Mr. Roger J Simpson, M.D.NPI 1871585281
Title
Owner
Phone
(308) 532-6165

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
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X NE Primary

Addresses

Primary practice location

106 E C St
North Platte, NE 69101-5411

Mailing address

106 E C St
North Platte, NE 69101-5411
Phone (308) 532-6165

Other identifiers 1

IdentifierTypeStateIssuer
53752953300MedicaidNE

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
28D1071268Ear Nose Throat & Sinus Clinic LLC106 East C Street, North Platte, NE 69101Certificate of waiverJul 22, 2027

National Provider Directory

National Provider Directory

Locations

106 E C St
North Platte, NE 69101
Phone (308) 532-6165

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332892800000",
    "number": "1255607891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 E C ST",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691015411",
            "telephone_number": "308-532-6165",
            "fax_number": "308-532-7464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 E C ST",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691015411",
            "telephone_number": "308-532-6165",
            "fax_number": "308-532-7464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR, NOSE, THROAT & SINUS CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-28",
        "last_updated": "2012-03-28",
        "status": "A",
        "authorized_official_last_name": "SIMPSON",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "308-532-6165",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "NE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "53752953300",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Platte, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.