Heritage of St Paul, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

434001 Issued in NE

Legal business name

HERITAGE OF ST PAUL, INC

Doing business as

Brookefield Park

Practice address

1405 Heritage Dr
Saint Paul, NE 68873-3618

Phone

(308) 754-5486

Fax

(308) 754-5385

NPI assigned

Aug 29, 2006

Last updated

Jul 17, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jack Dean Vetter

Title

President

Phone

(402) 895-3932

Specialties & licenses 1

Addresses

Other names 1

• Brookefield Park Doing business as

Locations

Practitioners 2

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.

• Jeffrey Mark Pollens, DPM

  • Podiatrist
  • Omaha, NE
  • NPI 1710943279
  NPD (past)
• Kelly Jean Simeon, PTA

  • Physical Therapy Assistant
  • Saint Paul, NE
  • NPI 1902190630
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374019200000",
    "number": "1457460230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 HERITAGE DR",
            "city": "SAINT PAUL",
            "state": "NE",
            "postal_code": "688733618",
            "telephone_number": "308-754-5486",
            "fax_number": "308-754-5385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 HERITAGE DR",
            "city": "SAINT PAUL",
            "state": "NE",
            "postal_code": "688733618",
            "telephone_number": "308-754-5486",
            "fax_number": "308-754-5385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE OF ST PAUL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2013-07-17",
        "status": "A",
        "authorized_official_last_name": "VETTER",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-895-3932"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NE",
            "license": "434001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookefield Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kaitlin D. Hahn, M.D.
• Neal John Hahn, PA-C
• Madison Hansen, RN
• Lindsay Heminger
• Louise Herbig, COTA-L
• Howard County Medical Center (HCMC Clinic - Non-RHC)
• Howard County Medical Center (Howard County Medical Clinic)
• Howard County Medical Center
• Howard County Medical Center
• Howard County Medical Center

• Skilled Nursing Facility in Saint Paul, NE
• Providers in Saint Paul, NE by specialty
• Skilled Nursing Facility in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; 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.