Individual provider Active NPI

Bruce L Town, PA-C

  • Physician Assistant
  • Blair, NE
National Provider Identifier
1285607036
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
849 Issued in NE
Practice address
812 N 22ND St
Blair, NE 68008-1128
Phone
(402) 426-4611
Fax
(402) 426-4642
NPI assigned
Feb 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 849 NE
Physician Assistant 363A00000X 849 NE Primary

Addresses

Primary practice location

812 N 22ND St
Blair, NE 68008-1128

Mailing address

812 N 22ND St
Blair, NE 68008-1128
Phone (402) 426-4611

Other practice location 1

812 N 22nd St
Blair, NE 68008-1128
Phone (402) 426-4611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140315000187 NE Practitioner - Physician Assistant 9931330974 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
849NEMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Community Hospital Corporation CurrentSince Dec 15, 2025 Accepting new patients

Locations

812 N 22nd St
Blair, NE 68008
Phone (402) 426-4611

810 N 22nd St
Blair, NE 68008
Phone (402) 426-1116

1420 Clark St
Fort Calhoun, NE 68023
Phone (402) 468-4655

120 S 9th St
Tekamah, NE 68061
Phone (402) 374-1585

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1285607036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 N 22ND ST",
            "city": "BLAIR",
            "state": "NE",
            "postal_code": "680081128",
            "telephone_number": "402-426-4611",
            "fax_number": "402-426-4642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 N 22ND ST",
            "city": "BLAIR",
            "state": "NE",
            "postal_code": "680081128",
            "telephone_number": "402-426-4611",
            "fax_number": "402-426-4642"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "812 N 22nd St",
            "address_purpose": "LOCATION",
            "city": "Blair",
            "state": "NE",
            "postal_code": "680081128",
            "country_code": "US",
            "telephone_number": "402-426-4611",
            "fax_number": "402-426-4642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOWN",
        "first_name": "BRUCE",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "849",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blair, NE

Sources for this page

Verify at the official NPI Registry.