Organization Active NPI

Family Dermatology of Nebraska LLC

  • Dermatology Physician
  • Lincoln, NE
National Provider Identifier
1376831362
Registry record updated May 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
FAMILY DERMATOLOGY OF NEBRASKA LLC
Practice address
2625 Stockwell St
Lincoln, NE 68502-5755
Phone
(402) 421-3335
Fax
(402) 421-2625
NPI assigned
Jul 12, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2012

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

Authorized official

Name
Paula M Nelson, MDNPI 1356333645
Title
Owner
Phone
(402) 421-3335

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
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X NE Primary
Dermatopathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0900X NE

Addresses

Primary practice location

2625 Stockwell St
Lincoln, NE 68502-5755

Mailing address

40 Morris Ave
Suite 150
Bryn Mawr, PA 19010-3300
Phone (215) 519-5487

National Provider Directory

National Provider Directory

Locations

40 Morris Ave
Ste 150
Bryn Mawr, PA 19010

Practitioners & affiliated clinicians

Practitioners 1

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": "1310428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335916800000",
    "number": "1376831362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 MORRIS AVE",
            "address_2": "SUITE 150",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103300",
            "telephone_number": "215-519-5487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 STOCKWELL ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685025755",
            "telephone_number": "402-421-3335",
            "fax_number": "402-421-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DERMATOLOGY OF NEBRASKA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-12",
        "last_updated": "2012-05-02",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-421-3335",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "NE",
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "NE",
            "license": null,
            "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 May 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.