NPIMap

Organization Active NPI

Nannen Physical Therapy and Personal Training

  • Physical Therapist
  • Blair, NE
National Provider Identifier
1275737322
Registry record updated Oct 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
NANNEN PHYSICAL THERAPY AND PERSONAL TRAINING
Practice address
636 N 20TH Ave
Blair, NE 68008-1116
Phone
(402) 426-3488
Fax
(402) 426-3553
NPI assigned
Jun 13, 2007
Last updated
Oct 12, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2007

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

Authorized official

Name
David M Nannen, PHYSICAL THERAPISTNPI 1326023144
Title
Owner
Phone
(402) 426-3488

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NE Primary

Addresses

Primary practice location

636 N 20TH Ave
Blair, NE 68008-1116

Mailing address

636 N 20TH Ave
Blair, NE 68008-1116
Phone (402) 426-3488

Other identifiers 1

IdentifierTypeStateIssuer
47036333032MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050224000265 NE Part B Supplier - Clinic/Group Practice 9931152402 Receives reassigned benefits from 9 practitioners
Practice locations: Blair, NE; Fort Calhoun, NE; North Bend, NE; Omaha, NE; Schuyler, NE; Tekamah, NE

National Provider Directory

National Provider Directory

Locations

636 N 20th Ave
Blair, NE 68008
Phone (402) 426-3488

515 N 14th St
Ste 102
Fort Calhoun, NE 68023
Phone (402) 426-3488

418 S 13th St
Tekamah, NE 68061
Phone (402) 426-3488

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192147200000",
    "number": "1275737322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 N 20TH AVE",
            "city": "BLAIR",
            "state": "NE",
            "postal_code": "680081116",
            "telephone_number": "402-426-3488",
            "fax_number": "402-426-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 N 20TH AVE",
            "city": "BLAIR",
            "state": "NE",
            "postal_code": "680081116",
            "telephone_number": "402-426-3488",
            "fax_number": "402-426-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NANNEN PHYSICAL THERAPY AND PERSONAL TRAINING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2007-10-12",
        "status": "A",
        "authorized_official_last_name": "NANNEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-426-3488",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47036333032",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blair, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.