NPIMap

Organization Active NPI

Fremont Health Clinic

  • Family Medicine Physician
  • Fremont, NE
National Provider Identifier
1376189506
Registry record updated Nov 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FREMONT HEALTH CLINIC
Practice address
350 W 23Rd St
Fremont, NE 68025-2592
Phone
(402) 721-7077
NPI assigned
Nov 22, 2019
Organization subpart
Yes
Parent organization
FREMONT HEALTH CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 22, 2019

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

Authorized official

Name
Brett M Richmond
Title
President
Phone
(402) 727-1610

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

350 W 23Rd St
Fremont, NE 68025-2592

Mailing address

2540 N Healthy Way
Fremont, NE 68025-2315
Phone (402) 727-1091

Other names 1

  • METHODIST PHYSICIANS CLINIC PRAIRIE FIELDS 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
28D1095679Methodist Physicians Clinic - Praire Fields350 West 23Rd Street, Fremont, NE 68025AccreditationMar 23, 2027

National Provider Directory

National Provider Directory
Part of
Fremont Health Clinic

Locations

930 2nd St
Dodge, NE 68633
Phone (402) 693-2212

680 E Fremont Medical Park Dr
Ste 200
Fremont, NE 68025
Phone (402) 941-1247

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1574380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574380800000",
    "number": "1376189506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2540 N HEALTHY WAY",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252315",
            "telephone_number": "402-727-1091",
            "fax_number": "402-727-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W 23RD ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252592",
            "telephone_number": "402-721-7077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREMONT HEALTH CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FREMONT HEALTH CLINIC",
        "enumeration_date": "2019-11-22",
        "last_updated": "2019-11-22",
        "status": "A",
        "authorized_official_last_name": "RICHMOND",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-727-1610"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "METHODIST PHYSICIANS CLINIC PRAIRIE FIELDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fremont, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2019; 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.