NPIMap

Organization Active NPI

Platte Valley Womens Healthcare, PC

  • Family Nurse Practitioner
  • North Platte, NE
National Provider Identifier
1316206923
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
110460 Issued in NE
Legal business name
PLATTE VALLEY WOMENS HEALTHCARE, PC
Practice address
810 W Reid Ave
Suite 4
North Platte, NE 69101-6583
Phone
(308) 534-0090
Fax
(308) 534-0091
NPI assigned
May 16, 2012
Last updated
Oct 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Authorized official

Name
Kelley A Hasenauer, APRNNPI 1780699132
Title
President/Owner
Phone
(308) 534-0090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 110460 NE Primary
Obstetrics & Gynecology Physician 207V00000X 18908 NE

Addresses

Primary practice location

810 W Reid Ave
Suite 4
North Platte, NE 69101-6583

Mailing address

810 W Reid Ave
Suite 4
North Platte, NE 69101-6583
Phone (308) 534-0090

Other practice location 1

207 NW 4th St
Mullen, NE 69152-5235
Phone (308) 546-2213

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140818000296 NE Part B Supplier - Clinic/Group Practice 9032336904 Receives reassigned benefits from 6 practitioners
Practice locations: Mullen, NE; North Platte, NE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1316206923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 W REID AVE",
            "address_2": "SUITE 4",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691016583",
            "telephone_number": "308-534-0090",
            "fax_number": "308-534-0091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 W REID AVE",
            "address_2": "SUITE 4",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691016583",
            "telephone_number": "308-534-0090",
            "fax_number": "308-534-0091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 NW 4th St",
            "address_purpose": "LOCATION",
            "city": "Mullen",
            "state": "NE",
            "postal_code": "691525235",
            "country_code": "US",
            "telephone_number": "308-546-2213",
            "fax_number": "308-534-0091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PLATTE VALLEY WOMENS HEALTHCARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-16",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "HASENAUER",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "308-534-0090",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "110460",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NE",
            "license": "18908",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Platte, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.