NPIMap

Organization Active NPI

Holdrege Medical Clinic, P.C.

Doing business as Family Medical Specialties

  • Internal Medicine Physician
  • Holdrege, NE
National Provider Identifier
1427089010
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HOLDREGE MEDICAL CLINIC, P.C.
Doing business as
Family Medical Specialties
Practice address
516 W 14TH Ave
Ste 100
Holdrege, NE 68949-1215
Phone
(308) 995-4431
Fax
(308) 995-3247
NPI assigned
Jul 5, 2006
Last updated
Jun 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Authorized official

Name
William Max Sandy, MDNPI 1841236692
Title
Ceo
Phone
(308) 995-4431

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
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

516 W 14TH Ave
Ste 100
Holdrege, NE 68949-1215

Mailing address

516 W 14TH Ave
Ste 100
Holdrege, NE 68949-1216
Phone (308) 995-4431

Other identifiers 1

IdentifierTypeStateIssuer
47063910813MedicaidNE

Other names 1

  • Family Medical Specialties Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040318001427 NE Part B Supplier - Clinic/Group Practice 2769372002 Receives reassigned benefits from 20 practitioners
Practice locations: Holdrege, NE
O20100930064346 NE DME Supplier - Physician - Family Practice 2769372002 Practice locations: Holdrege, NE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1427089010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 W 14TH AVE",
            "address_2": "STE 100",
            "city": "HOLDREGE",
            "state": "NE",
            "postal_code": "689491216",
            "telephone_number": "308-995-4431",
            "fax_number": "308-995-3247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 W 14TH AVE",
            "address_2": "STE 100",
            "city": "HOLDREGE",
            "state": "NE",
            "postal_code": "689491215",
            "telephone_number": "308-995-4431",
            "fax_number": "308-995-3247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLDREGE MEDICAL CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "SANDY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "MAX",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "308-995-4431",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47063910813",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Medical Specialties",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Holdrege, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.