NPIMap

Individual provider Active NPI

Lindsay Carolyn Northam, M.D.

  • Internal Medicine Physician
  • Elkhorn, NE
National Provider Identifier
1306077078
Registry record updated Jan 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
6094 Issued in NE
Practice address
717 N 190TH PLZ
Ste. 3200
Elkhorn, NE 68022-3913
Phone
(402) 815-1960
Fax
(402) 815-1961
NPI assigned
Jul 29, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 6094 NE Primary

Addresses

Primary practice location

717 N 190TH PLZ
Ste. 3200
Elkhorn, NE 68022-3913

Mailing address

PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100

Other identifiers 2

IdentifierTypeStateIssuer
10026293200MedicaidNE
1306077078MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130724000714 NE Practitioner - Internal Medicine 2365683984 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Univ of Nebraska Medical Center, Col of Dentistry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians

Practice addresses (Care Compare)

717 N 190TH PLZ
Suite 3200
Elkhorn, NE 68022-3913
Phone (402) 815-1960

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6094NEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Clinic Inc Internal Medicine CurrentSince Jun 30, 2013 Accepting new patients
Nebraska Methodist Hospital Current Accepting new patients
VSL Elkhorn LLC Past Accepting new patients

Locations

717 N 190th Plz
Ste 3200
Elkhorn, NE 68022
Phone (402) 815-1960

4330 S 144th St
Omaha, NE 68137
Phone (402) 397-3626

8601 W Dodge Rd
Ste 216
Omaha, NE 68114
Phone (402) 354-4822

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

101 E Centennial Rd
Papillion, NE 68046
Phone (402) 354-7750

24110 W Dodge Rd
Waterloo, NE 68069
Phone (402) 359-2277

Interoperability endpoints

  • Direct secure messaging: lindsay.northam@direct.nmhs.org

Organizations & group practices 3

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1248825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388707200000",
    "number": "1306077078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 N 190TH PLZ",
            "address_2": "STE. 3200",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680223913",
            "telephone_number": "402-815-1960",
            "fax_number": "402-815-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHAM",
        "first_name": "LINDSAY",
        "middle_name": "CAROLYN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-29",
        "last_updated": "2014-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "6094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026293200",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306077078",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhorn, NE

Sources for this page

Verify at the official NPI Registry.