Nebraska Medical Mart II Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

001011468033 Issued in NE

Legal business name

NEBRASKA MEDICAL MART II INC

Doing business as

Nebraska Medical Mart

Practice address

115 E 6TH St
York, NE 68467-2917

Phone

(800) 633-6323

Fax

(402) 727-7682

NPI assigned

Mar 21, 2013

Last updated

Mar 21, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

NEBRASKA MEDICAL MART II INCAs reported in NPPES

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

Authorized official

Name

Heather Klanecky

Title

Billing Rep

Phone

(402) 727-4270

Specialties & licenses 1

Addresses

Other names 1

• Nebraska Medical Mart Doing business as

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Nebraska Medical Mart II Inc

  dba Nebraska Medical Mart

  • Durable Medical Equipment & Medical Supplies
  • Fremont, NE
  • NPI 1841376076

  9638295280

  Same PAC ID

Tax ID family

Nebraska Medical Mart II Inc2 organizations share this tax ID, including this one

Part of

Nebraska Medical Mart II Inc

Other organizations with this tax ID 1

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

• Nebraska Medical Mart II Inc

  dba Nebraska Medical Mart

  • Durable Medical Equipment & Medical Supplies
  • Fremont, NE
  • NPI 1841376076
  NPD tax ID

Locations

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.

• Nebraska Medical Mart II Inc

  dba Nebraska Medical Mart

  • Durable Medical Equipment & Medical Supplies
  • Fremont, NE
  • NPI 1841376076
  NPPES parent name

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

{
    "created_epoch": "1363824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363824000000",
    "number": "1376885921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 N BELL ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680253534",
            "telephone_number": "402-727-4270",
            "fax_number": "402-727-7682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E 6TH ST",
            "city": "YORK",
            "state": "NE",
            "postal_code": "684672917",
            "telephone_number": "800-633-6323",
            "fax_number": "402-727-7682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEBRASKA MEDICAL MART II INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEBRASKA MEDICAL MART II INC",
        "enumeration_date": "2013-03-21",
        "last_updated": "2013-03-21",
        "status": "A",
        "authorized_official_last_name": "KLANECKY",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "BILLING REP",
        "authorized_official_telephone_number": "402-727-4270"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NE",
            "license": "001011468033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nebraska Medical Mart",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Madison J Nutter, PA
• Randy Scott Obermier, CPED

• Durable Medical Equipment & Medical Supplies in York, NE
• Providers in York, NE by specialty
• Durable Medical Equipment & Medical Supplies in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2013; 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.

Verify at the official NPI Registry.