Active NPI
Callaway Hospital District
- Family Medicine Physician
- Callaway, NE
National Provider Identifier
1508979899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- CALLAWAY HOSPITAL DISTRICT
- Practice address
- 211 E Kimball St
Callaway, NE 68825-2597 - Phone
- (308) 836-2228
- Fax
- (308) 836-2733
- NPI assigned
- Aug 17, 2006
- Organization subpart
- Yes
- Parent organization
- CALLAWAY HOSPITAL DISTRICT
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Brett D Eggleston
- Title
- Ceo
- Phone
- (308) 836-2228
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary | ||
| Medical Physician Assistant | 363AM0700X |
Addresses
Primary practice location
211 E Kimball St
Callaway, NE 68825-2597
Mailing address
PO Box 100
Callaway, NE 68825-0100
Phone (308) 836-2228
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025136800 | Medicaid | NE | |
| DC3835 | Other | NE | MEDICARE RAILROAD |
| 04058 | Other | NE | BCBS OF NEBRASKA |
| 10025136700 | Medicaid | NE |
Other names 1
- Callaway Hospital Professional Services
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040714000240 | NE | Part B Supplier - Clinic/Group Practice | 0143208983 |
Receives reassigned benefits from 7 practitioners Practice locations: Callaway, NE |
Other NPIs with the same Medicare PAC ID 4
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Medicare Defined Swing Bed Hospital Unit
- Callaway, NE
- NPI 1871600981
0143208983
National Provider Directory
National Provider Directory- Part of
- Callaway Hospital District
Locations
104 N Broadway St
Arnold, NE 69120
Phone (308) 848-3259
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Critical Access Hospital
- Callaway, NE
- NPI 1740397850
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1547596800000",
"number": "1508979899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 100",
"city": "CALLAWAY",
"state": "NE",
"postal_code": "688250100",
"telephone_number": "308-836-2228",
"fax_number": "308-836-2733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 E KIMBALL ST",
"city": "CALLAWAY",
"state": "NE",
"postal_code": "688252597",
"telephone_number": "308-836-2228",
"fax_number": "308-836-2733"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CALLAWAY HOSPITAL DISTRICT",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "CALLAWAY HOSPITAL DISTRICT",
"enumeration_date": "2006-08-17",
"last_updated": "2019-01-16",
"status": "A",
"authorized_official_last_name": "EGGLESTON",
"authorized_official_first_name": "BRETT",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "308-836-2228",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025136800",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "DC3835",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF NEBRASKA",
"identifier": "04058",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025136700",
"state": "NE"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Callaway Hospital Professional Services",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Callaway Hospital Professional Services",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Callaway, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.