NPIMap

Organization Active NPI

Midtown Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Norfolk, NE
National Provider Identifier
1407409261
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MIDTOWN HEALTH CENTER, INC.
Practice address
611 Meadow LN
Norfolk, NE 68701-7215
Phone
(402) 371-8000
Fax
(402) 371-0971
NPI assigned
Jul 22, 2019
Organization subpart
Yes
Parent organization
MIDTOWN HEALTH CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

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

Authorized official

Name
Melodee J Drenkow
Title
Systems Auditor/Credentialing
Phone
(402) 370-1064

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

611 Meadow LN
Norfolk, NE 68701-7215

Mailing address

302 W Phillip Ave
Norfolk, NE 68701-5248
Phone (402) 371-8000

Other names 1

  • Midtown Health Center--Woodland Park Elementary School Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240821002821 NE Part A Provider - Federally Qualified Health Center (FQHC) 9133110182 Practice locations: Norfolk, NE

Federally qualified health center certification: CCN D01010

Legal name
MIDTOWN HEALTH CENTER INC
Doing business as
MIDTOWN HEALTH CENTER-WOODLAND PARK ELEMENTARY SCHOOL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 15, 2024
Last certification
Aug 15, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 13, 2014 in NE
Enrollment address
611 Meadow LN
Norfolk, NE 68701-7215

Other NPIs with the same Medicare PAC ID 16

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

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Midtown Health Center Inc19 organizations share this tax ID, including this one
Part of
Midtown Health Center Inc

Other organizations with this tax ID 18

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

View all 18

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Betty Froehlich Individual Corporate OfficerPast Chairman Jan 1, 2004
Gretchen Forsell Individual Corporate OfficerBoard Member Jan 1, 2004
Mary Luhr Individual Corporate OfficerBoard Member Jan 1, 2016
Karie Langhorst Individual Corporate OfficerChief Financial Officer Jan 1, 2022
Brenda Jones Individual Corporate OfficerSecretary Jan 1, 2008
Lance Morrow Individual Corporate OfficerTreasurer Jan 1, 2016
Susie Lutz Individual Corporate OfficerBoard Chairman Jan 1, 2015
Karen Weidner Individual Corporate OfficerBoard Member Jan 1, 2001
Kathy Nordby Individual Corporate OfficerChief Executive Officer Oct 1, 2011 100%
W-2 Managing EmployeeAd; Jan 1, 2011
Melodee Drenkow Individual Corporate Officer Mar 15, 2024
Corporate DirectorQuality Management Director Sep 1, 2021

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Midtown Health Center IncNorfolk, NE, CCN 281812 Federally qualified health center Operational/Managerial Control Aug 1, 2008
Midtown Health Center - MadisonMadison, NE, CCN 281813 Federally qualified health center Operational/Managerial Control Apr 6, 2009

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

NPI Registry JSON

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594252800000",
    "number": "1407409261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 W PHILLIP AVE",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687015248",
            "telephone_number": "402-371-8000",
            "fax_number": "402-371-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 MEADOW LN",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687017215",
            "telephone_number": "402-371-8000",
            "fax_number": "402-371-0971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDTOWN HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIDTOWN HEALTH CENTER, INC.",
        "enumeration_date": "2019-07-22",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A",
        "authorized_official_last_name": "DRENKOW",
        "authorized_official_first_name": "MELODEE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SYSTEMS AUDITOR/CREDENTIALING",
        "authorized_official_telephone_number": "402-370-1064"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midtown Health Center--Woodland Park Elementary School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norfolk, NE

Sources for this page

Verify at the official NPI Registry.