NPIMap

Organization Active NPI

Nebraska City Physical Therapy, LLC

Doing business as Exstrom Physical Therapy

  • Physical Therapy Clinic/Center
  • Nebraska City, NE
National Provider Identifier
1437453164
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
NEBRASKA CITY PHYSICAL THERAPY, LLC
Doing business as
Exstrom Physical Therapy
Practice address
1104 Grundman Blvd
Nebraska City, NE 68410-3397
Phone
(402) 873-7411
Fax
(402) 873-7413
NPI assigned
Jan 10, 2011
Last updated
Apr 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Authorized official

Name
Darrell Metcalf
Title
Ceo
Phone
(402) 334-6027

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

1104 Grundman Blvd
Nebraska City, NE 68410-3397

Mailing address

1104 Grundman Blvd
Nebraska City, NE 68410-3397
Phone (402) 873-7411

Other identifiers 3

IdentifierTypeStateIssuer
100258032-00MedicaidNE
100259310-01MedicaidNE
100259310-00MedicaidNE

Other names 1

  • Exstrom Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110314000281 NE Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4486836301 Receives reassigned benefits from 16 practitioners
Practice locations: Lincoln, NE; Nebraska City, NE; Seward, NE

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3818 Normal Blvd
Lincoln, NE 68506
Phone (402) 488-4282

6319 Havelock Ave
Lincoln, NE 68507
Phone (402) 325-0044

1104 Grundman Blvd
Nebraska City, NE 68410
Phone (402) 873-7411

510 Bradford St
Ste B
Seward, NE 68434
Phone (402) 646-2007

Practitioners & affiliated clinicians

Practitioners 39

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 39

NPI Registry JSON

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

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744243200000",
    "number": "1437453164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 GRUNDMAN BLVD",
            "city": "NEBRASKA CITY",
            "state": "NE",
            "postal_code": "684103397",
            "telephone_number": "402-873-7411",
            "fax_number": "402-873-7413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 GRUNDMAN BLVD",
            "city": "NEBRASKA CITY",
            "state": "NE",
            "postal_code": "684103397",
            "telephone_number": "402-873-7411",
            "fax_number": "402-873-7413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEBRASKA CITY PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-10",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A",
        "authorized_official_last_name": "METCALF",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "402-334-6027"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100258032-00",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100259310-01",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100259310-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Exstrom Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nebraska City, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; 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.