Premier Estates of Pawnee, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PREMIER ESTATES OF PAWNEE, LLC

Practice address

438 12TH St
Pawnee City, NE 68420-3589

Phone

(402) 852-2975

Fax

(402) 852-2979

NPI assigned

Apr 30, 2015

Last updated

Oct 10, 2015By 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

Gregory Shayne Bench

Title

Cfo

Phone

(941) 758-4745

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Kent Joseph Niss, MD

  • Family Medicine Physician
  • Pawnee City, NE
  • NPI 1942734298
  NPD (past)

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

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444435200000",
    "number": "1497132237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5265 OFFICE PARK BLVD",
            "address_2": "SUITE 101",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342033441",
            "telephone_number": "941-758-4745",
            "fax_number": "941-751-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 12TH ST",
            "city": "PAWNEE CITY",
            "state": "NE",
            "postal_code": "684203589",
            "telephone_number": "402-852-2975",
            "fax_number": "402-852-2979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER ESTATES OF PAWNEE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-30",
        "last_updated": "2015-10-10",
        "status": "A",
        "authorized_official_last_name": "BENCH",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "SHAYNE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "941-758-4745"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100265081-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pawnee County Memorial Hospital
• Pawnee County Memorial Hospital
• Pawnee County Memorial Hospital (Pawnee County Rural Health Clinic)
• Pawnee County Memorial Hospital
• Petes Pharmacy Inc (Petes Pharmacy)
• Carrie Ann Ramsey, PA-C
• Melissa Roland
• Jessica Marie Ronnebaum, DPT
• Shaina Russell
• Beverly Smith

• Skilled Nursing Facility in Pawnee City, NE
• Providers in Pawnee City, 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 Oct 10, 2015; 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.