NPIMap

Organization Active NPI

North Platte Regional Urology, LLC

  • Urology Physician
  • North Platte, NE
National Provider Identifier
1497892673
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
20757 Issued in NE
Legal business name
NORTH PLATTE REGIONAL UROLOGY, LLC
Practice address
611 W Francis St
North Platte, NE 69101-0620
Phone
(719) 393-2137
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Michael Gallentine
Title
Urologist Sole Proprietor Owner
Phone
(719) 393-2137

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X 20757 NE Primary

Addresses

Primary practice location

611 W Francis St
North Platte, NE 69101-0620

Mailing address

4455 Stonehaven Dr
Colorado Springs, CO 80906-4897

Other identifiers 1

IdentifierTypeStateIssuer
1356311583OtherPERSONAL NPI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497892673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 STONEHAVEN DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809064897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W FRANCIS ST",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691010620",
            "telephone_number": "719-393-2137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH PLATTE REGIONAL UROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GALLENTINE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "UROLOGIST SOLE PROPRIETOR OWNER",
        "authorized_official_telephone_number": "719-393-2137"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "NE",
            "license": "20757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1356311583",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Platte, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.