Organization Active NPI

Northeast Nebraska Pain Medicine LLC

  • Pain Medicine Physician
  • Norfolk, NE
National Provider Identifier
1417257403
Registry record updated Dec 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
NORTHEAST NEBRASKA PAIN MEDICINE LLC
Practice address
1414 N 13TH St
Norfolk, NE 68701-2669
Phone
(402) 316-4027
Fax
(402) 316-3469
NPI assigned
Oct 25, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2015

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

Authorized official

Name
Christopher E Price, MD
Title
Owner
Phone
(402) 644-7506

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0000X Primary

Addresses

Primary practice location

1414 N 13TH St
Norfolk, NE 68701-2669

Mailing address

PO Box 5126
Sioux Falls, SD 57117-5126
Phone (605) 335-1952

Other identifiers 1

IdentifierTypeStateIssuer
10025914600MedicaidNE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449705600000",
    "number": "1417257403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5126",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175126",
            "telephone_number": "605-335-1952",
            "fax_number": "605-373-9971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 N 13TH ST",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687012669",
            "telephone_number": "402-316-4027",
            "fax_number": "402-316-3469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST NEBRASKA PAIN MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-25",
        "last_updated": "2015-12-10",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-644-7506",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025914600",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; 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.