NPIMap

Organization Active NPI

Memorial Community Hospital Corporation

Doing business as Blair Clinic

  • Clinic/Center
  • Blair, NE
National Provider Identifier
1285767236
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
MEMORIAL COMMUNITY HOSPITAL CORPORATION
Doing business as
Blair Clinic
Practice address
812 N. 22ND Street
Blair, NE 68008-1128
Phone
(402) 426-4611
Fax
(402) 426-4642
NPI assigned
Mar 13, 2007
Last updated
Oct 4, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
MEMORIAL COMMUNITY HOSPITAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Authorized official

Name
Amy Zimmer
Title
Cne/VP Patient Care Services
Phone
(402) 426-2182

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

812 N. 22ND Street
Blair, NE 68008-1128

Mailing address

P.O Box 286
Blair, NE 68008-1128
Phone (402) 426-4611

Other identifiers 1

IdentifierTypeStateIssuer
01802OtherNEBLUE CROSS

Other names 1

  • Blair Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040202001065 NE Part B Supplier - Clinic/Group Practice 0749190775 Receives reassigned benefits from 84 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tekamah, NE; Fort Calhoun, NE; Blair, NE

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Memorial Comm Hospital

Locations

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1285767236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O BOX 286",
            "city": "BLAIR",
            "state": "NE",
            "postal_code": "680081128",
            "telephone_number": "402-426-4611",
            "fax_number": "402-426-1297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 N. 22ND STREET",
            "city": "BLAIR",
            "state": "NE",
            "postal_code": "680081128",
            "telephone_number": "402-426-4611",
            "fax_number": "402-426-4642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL COMMUNITY HOSPITAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMORIAL COMMUNITY HOSPITAL CORPORATION",
        "enumeration_date": "2007-03-13",
        "last_updated": "2023-10-04",
        "certification_date": "2023-01-10",
        "status": "A",
        "authorized_official_last_name": "ZIMMER",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CNE/VP PATIENT CARE SERVICES",
        "authorized_official_telephone_number": "402-426-2182"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "01802",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blair Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Blair Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 4, 2023; 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.