Active NPI
York Medical Clinic, P.C.
- Family Medicine Physician
- York, NE
National Provider Identifier
1376596809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- YORK MEDICAL CLINIC, P.C.
- Practice address
- 2114 N Lincoln Ave Ste a
York, NE 68467-1072 - Phone
- (402) 362-5555
- NPI assigned
- May 18, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kitti Nienhueser
- Title
- Credentialing Coordinator
- Phone
- (402) 362-0615
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
2114 N Lincoln Ave Ste a
York, NE 68467-1072
Mailing address
2114 N Lincoln Avenue
Suite a
York, NE 68467-1028
Phone (402) 362-5555
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28-3834 | Other | RURAL HEALTH | |
| 098044 | Other | NE | PTAN SMC |
| 28-3819 | Other | RURAL HEALTH | |
| 098043 | Other | NE | PTAN EMC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040520000960 | NE | Part B Supplier - Clinic/Group Practice | 7113918939 |
Receives reassigned benefits from 18 practitioners 2 other NPIs on this enrollment Practice locations: York, NE |
National Provider Directory
National Provider DirectoryLocations
2114 N Lincoln Ave
York, NE 68467
Phone (402) 362-5044
2101 N Lincoln Ave
York, NE 68467
Phone (402) 362-2621
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/FDDFDD
Practitioners & affiliated clinicians
Practitioners 19
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": "1147910400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1714348800000",
"number": "1376596809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2114 N LINCOLN AVENUE",
"address_2": "SUITE A",
"city": "YORK",
"state": "NE",
"postal_code": "684671028",
"telephone_number": "402-362-5555",
"fax_number": "402-362-7137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2114 N LINCOLN AVE STE A",
"city": "YORK",
"state": "NE",
"postal_code": "684671072",
"telephone_number": "402-362-5555"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "YORK MEDICAL CLINIC, P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-18",
"last_updated": "2024-04-29",
"certification_date": "2024-04-29",
"status": "A",
"authorized_official_last_name": "NIENHUESER",
"authorized_official_first_name": "KITTI",
"authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
"authorized_official_telephone_number": "402-362-0615"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RURAL HEALTH",
"identifier": "28-3834",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN SMC",
"identifier": "098044",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RURAL HEALTH",
"identifier": "28-3819",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN EMC",
"identifier": "098043",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in York, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.