Lone Tree Medical Associates, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LONE TREE MEDICAL ASSOCIATES, P.C.

Practice address

901 Broadway St
Fullerton, NE 68638-3151

Phone

(308) 536-2458

Fax

(308) 536-2459

NPI assigned

Sep 25, 2006

Last updated

Nov 26, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

LONE TREE MEDICAL ASSOCIATES, P.C.As reported in NPPES

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

Authorized official

Name

Steven Scot Mahnke, M.D.NPI 1699880385

Title

Corporate Officer

Phone

(308) 946-3845

Specialties & licenses 4

Addresses

Other identifiers 3

Part of

Lone Tree Medical Ass0Cs PC

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.

• Lone Tree Medical Associates, P.C.

  • Family Medicine Physician
  • Central City, NE
  • NPI 1700991510
  NPPES parent name

Practitioners 1

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.

• Steven Scot Mahnke, M.D.

  • Family Medicine Physician
  • Central City, NE
  • NPI 1699880385
  Authorized official Same address or phone

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353888000000",
    "number": "1427158690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 18TH AVE",
            "city": "CENTRAL CITY",
            "state": "NE",
            "postal_code": "688262123",
            "telephone_number": "308-946-3845",
            "fax_number": "308-946-2357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 BROADWAY ST",
            "city": "FULLERTON",
            "state": "NE",
            "postal_code": "686383151",
            "telephone_number": "308-536-2458",
            "fax_number": "308-536-2459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONE TREE MEDICAL ASSOCIATES, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LONE TREE MEDICAL ASSOCIATES, P.C.",
        "enumeration_date": "2006-09-25",
        "last_updated": "2012-11-26",
        "status": "A",
        "authorized_official_last_name": "MAHNKE",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "SCOT",
        "authorized_official_title_or_position": "CORPORATE OFFICER",
        "authorized_official_telephone_number": "308-946-3845",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NE",
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS CLIA IDENTIFICATION #",
            "identifier": "28D0886128",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CD8193",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025126000",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Fullerton, NE
• Providers in Fullerton, NE by specialty
• Family Medicine Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; 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.