NPIMap

Organization Active NPI

Physicians Clinic Inc

Doing business as Methodist Physicians Clinic

  • Durable Medical Equipment & Medical Supplies
  • Elkhorn, NE
National Provider Identifier
1366060105
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PHYSICIANS CLINIC INC
Doing business as
Methodist Physicians Clinic
Practice address
20021 Manderson St
Elkhorn, NE 68022-3233
Phone
(402) 815-6600
NPI assigned
Jul 8, 2020
Last updated
Jul 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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

Authorized official

Name
Keri Charron
Title
Director
Phone
(402) 354-5602

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

20021 Manderson St
Elkhorn, NE 68022-3233

Mailing address

PO Box 3755
Omaha, NE 68103-0755

Other names 1

  • Methodist Physicians Clinic Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
28D2191463Methodist Physicians Clinic - Elkhorn20021 Manderson St, Elkhorn, NE 68022AccreditationAug 10, 2027

National Provider Directory

National Provider Directory
Tax ID family
William B Lockee MD15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594166400000",
    "number": "1366060105",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20021 MANDERSON ST",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680223233",
            "telephone_number": "402-815-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-08",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A",
        "authorized_official_last_name": "CHARRON",
        "authorized_official_first_name": "KERI",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "402-354-5602"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Methodist Physicians Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elkhorn, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.