Santa Marianita Clinic, Inc

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

15892 Issued in NE

Legal business name

SANTA MARIANITA CLINIC, INC

Practice address

1112 Verges Ave
Norfolk, NE 68701-3853

Phone

(402) 379-8717

Fax

(402) 379-0447

NPI assigned

Jul 8, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Rodrigo Gomez-Cordero, M.D

Title

Owner

Phone

(402) 379-8717

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Josie Lanai Clark

  • Physician Assistant
  • Norfolk, NE
  • NPI 1750846374
  NPD
• Jose Luis Nuno, PA-C

  • Physician Assistant
  • Norfolk, NE
  • NPI 1760990105
  NPD

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335484800000",
    "number": "1477586139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 VERGES AVE",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687013853",
            "telephone_number": "402-379-8717",
            "fax_number": "402-379-0447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 VERGES AVE",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687013853",
            "telephone_number": "402-379-8717",
            "fax_number": "402-379-0447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA MARIANITA CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2012-04-27",
        "status": "A",
        "authorized_official_last_name": "GOMEZ-CORDERO",
        "authorized_official_first_name": "RODRIGO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-379-8717",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NE",
            "license": "15892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "06484",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "2407",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leilianys Idelsa Sanchez
• Sinai Sanchez
• Cassandra Sanders
• Elizabeth Sanne
• Tamara Kaye Sanne, BS
• Brissa Sujay Santillan
• Edgar Anthony Santillan
• Jiah Kay Santillan
• Nabin Sapkota, MD
• Jamie Satterly, PHARMD

• Health Service Clinic/Center in Norfolk, NE
• Providers in Norfolk, NE by specialty
• Health Service Clinic/Center in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.