NPIMap

Organization Active NPI

Midtown Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Norfolk, NE
National Provider Identifier
1487837696
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
HC050 Issued in NE
Legal business name
MIDTOWN HEALTH CENTER, INC.
Practice address
302 W Phillip Ave
Norfolk, NE 68701-5248
Phone
(402) 371-8000
Fax
(402) 371-0971
NPI assigned
Dec 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

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

Authorized official

Name
Kathy Nordby
Title
Executive Director
Phone
(402) 370-1060

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X HC050 NE
Public Health DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223D0001X HC050 NE
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X HC050 NE
Community Health Clinic/Center 261QC1500X HC050 NE
Federally Qualified Health Center (FQHC) 261QF0400X HC050 NE Primary

Addresses

Primary practice location

302 W Phillip Ave
Norfolk, NE 68701-5248

Mailing address

302 W Phillip Ave
Norfolk, NE 68701-5248
Phone (402) 371-8000

Other identifiers 3

IdentifierTypeStateIssuer
10025728800OtherNEMEDICAID MENTAL HEALTH
10025126400MedicaidNE
10025704700OtherNEMEDICAID FQHC

Other names 1

  • Norfolk Community Health Care Clinic, Inc. Former legal business name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040519001227 NE Part B Supplier - Clinic/Group Practice 9133110182 Receives reassigned benefits from 17 practitioners
6 other NPIs on this enrollment
Practice locations: Norfolk, NE; Madison, NE
O20090406000021 NE Part A Provider - Federally Qualified Health Center (FQHC) 9133110182 Practice locations: Norfolk, NE

Federally qualified health center certification: CCN 281812

Legal name
MIDTOWN HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 6, 2009
Last certification
Apr 6, 2009
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 9, 2009 in NE
Enrollment address
302 W Phillip Ave
Norfolk, NE 68701-5248

Other NPIs with the same Medicare PAC ID 16

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 16

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1101 N 18th St
Norfolk, NE 68701
Phone (402) 644-2539

210 S 3rd St
Norfolk, NE 68701

423 W Madison Ave
Norfolk, NE 68701

611 Meadow Ln
Norfolk, NE 68701
Phone (402) 644-2500

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kathy Nordby Individual Corporate OfficerExecutive Director Oct 4, 2011 100%
Corporate DirectorExecutive Director Oct 4, 2011 100%
W-2 Managing EmployeeExecutive Director Oct 4, 2011 100%
Operational/Managerial ControlExecutive Director Oct 4, 2011 100%
Midtown Health Center Inc Organization, Norfolk, NE Non-profit Operational/Managerial Control Aug 1, 2008

Owners & managing parties with NPI records 16

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 16

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Midtown Health Center - MadisonMadison, NE, CCN 281813 Federally qualified health center Operational/Managerial Control Apr 6, 2009

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Subparts reporting this organization as parent 23

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

View all 23

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594252800000",
    "number": "1487837696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 W PHILLIP AVE",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687015248",
            "telephone_number": "402-371-8000",
            "fax_number": "402-371-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W PHILLIP AVE",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687015248",
            "telephone_number": "402-371-8000",
            "fax_number": "402-371-0971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDTOWN HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-11",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A",
        "authorized_official_last_name": "NORDBY",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "402-370-1060"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "HC050",
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": "NE",
            "license": "HC050",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "HC050",
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NE",
            "license": "HC050",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NE",
            "license": "HC050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID MENTAL HEALTH",
            "identifier": "10025728800",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025126400",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID FQHC",
            "identifier": "10025704700",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Norfolk Community Health Care Clinic, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Norfolk, NE

Sources for this page

Verify at the official NPI Registry.