Physicians Laboratory, PC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PHYSICIANS LABORATORY, PC

Practice address

4840 F St
Omaha, NE 68117-1407

Phone

(402) 731-4145

Fax

(401) 731-8653

NPI assigned

Oct 23, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Blaine Y Roffman, M.D.

Title

President

Phone

(402) 731-4145

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeremy Dean Berg, MD

  • Forensic Pathology Physician
  • Omaha, NE
  • NPI 1194112581
  NPD (past)
• Joslin Marie Carson, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Omaha, NE
  • NPI 1104137512
  NPD (past)
• Edward Paul Laine, DO

  • Anatomic Pathology & Clinical Pathology Physician
  • Knoxville, TN
  • NPI 1972583102
  NPD (past)

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306929617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4840 F ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681171407",
            "telephone_number": "402-731-4145",
            "fax_number": "401-731-8653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4840 F ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681171407",
            "telephone_number": "402-731-4145",
            "fax_number": "401-731-8653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS LABORATORY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROFFMAN",
        "authorized_official_first_name": "BLAINE",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-731-4145",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Physicians Clinic, Inc.
• Physicians Clinic, Inc.
• Physicians Clinic, Inc.
• Physicians Clinic, Inc.
• Physicians Laboratory Services, Inc
• Physicians of Internal Medicine, PC
• Physiotherapy Associates Inc
• Physiotherapy Associates Inc
• Physiotherapy Associates Inc
• Physiotherapy Associates Inc

• Clinical Medical Laboratory in Omaha, NE
• Providers in Omaha, NE by specialty
• Clinical Medical Laboratory in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.