NPIMap

Organization Active NPI

Pemberly Place Medical Clinic LLC

  • Primary Care Nurse Practitioner
  • Lincoln, NE
National Provider Identifier
1396231692
Registry record updated Jul 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
PEMBERLY PLACE MEDICAL CLINIC LLC
Practice address
7655 Archer Place
Lincoln, NE 68516
Phone
(531) 500-3650
NPI assigned
Jul 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2018

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

Authorized official

Name
Kristin M Butterfield, MSN, APRN, FNPNPI 1508352808
Title
Nurse Practitioner
Phone
(531) 500-3018

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
Gerontology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LG0600X
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X Primary

Addresses

Primary practice location

7655 Archer Place
Lincoln, NE 68516

Mailing address

7655 Archer Place
Lincoln, NE 68516
Phone (531) 500-3650

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18333/brand/1/csg/1/fhir/r4

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": "1531180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531180800000",
    "number": "1396231692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7655 ARCHER PLACE",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "68516",
            "telephone_number": "531-500-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7655 ARCHER PLACE",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "68516",
            "telephone_number": "531-500-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEMBERLY PLACE MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-10",
        "last_updated": "2018-07-10",
        "status": "A",
        "authorized_official_last_name": "BUTTERFIELD",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "531-500-3018",
        "authorized_official_credential": "MSN, APRN, FNP"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Jul 10, 2018; 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.