Organization Active NPI

Williamsburg Family Physicians P.C.

  • Primary Care Clinic/Center
  • Lincoln, NE
National Provider Identifier
1366406928
Registry record updated Jan 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
17216 Issued in NE
Legal business name
WILLIAMSBURG FAMILY PHYSICIANS P.C.
Practice address
6041 Village Dr
Suite 130
Lincoln, NE 68516-6619
Phone
(402) 423-1382
Fax
(402) 423-3590
NPI assigned
Apr 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2011

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

Authorized official

Name
Richard J Jirovec, M.D.
Title
Owner
Phone
(402) 423-1382

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 17216 NE Primary
Primary Care Clinic/Center 261QP2300X 356 NE

Addresses

Primary practice location

6041 Village Dr
Suite 130
Lincoln, NE 68516-6619

Mailing address

6041 Village Dr
Suite 130
Lincoln, NE 68516-6619
Phone (402) 423-1382

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050207000768 NE Part B Supplier - Clinic/Group Practice 7618928664 Receives reassigned benefits from 2 practitioners
Practice locations: Lincoln, NE

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
28D0455332Williamsburg Family Physicians6041 Village Drive, Suite 130, Lincoln, NE 68516Certificate of waiverNov 6, 2027

National Provider Directory

National Provider Directory

Locations

6041 Village Dr
Ste 130
Lincoln, NE 68516
Phone (402) 423-1382

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295481600000",
    "number": "1366406928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6041 VILLAGE DR",
            "address_2": "SUITE 130",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685166619",
            "telephone_number": "402-423-1382",
            "fax_number": "402-423-3590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6041 VILLAGE DR",
            "address_2": "SUITE 130",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685166619",
            "telephone_number": "402-423-1382",
            "fax_number": "402-423-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMSBURG FAMILY PHYSICIANS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-12",
        "last_updated": "2011-01-20",
        "status": "A",
        "authorized_official_last_name": "JIROVEC",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-423-1382",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NE",
            "license": "17216",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NE",
            "license": "356",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.