Individual provider Active NPI

Derek Lonowski, DPT

  • Physical Therapist
  • Kearney, NE
National Provider Identifier
1518534783
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4206 Issued in NE
Practice address
3811 Central Ave Ste F
Kearney, NE 68847-8173
Phone
(308) 237-0591
Fax
(308) 237-4251
NPI assigned
Jun 7, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4206 NE Primary

Addresses

Primary practice location

3811 Central Ave Ste F
Kearney, NE 68847-8173

Mailing address

PO Box 435
Broken Bow, NE 68822-0435
Phone (308) 872-5111

Other practice location 1

325 S 1st Ave
Broken Bow, NE 68822-2213
Phone (308) 872-5111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210716001951 NE Practitioner - Physical Therapist in Private Practice 7113329848 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Team Physical Therapy, P.C. Physical Therapist CurrentSince Jun 14, 2021 Accepting new patients
Team Physical Therapy, P.C. CurrentSince Jun 14, 2021 Accepting new patients
Nebraska City Physical Therapy, LLC Physical Therapist CurrentSince Jul 22, 2024 Accepting new patients
Havelock Physical Therapy LLC Physical Therapist PastSince Dec 19, 2016 Accepting new patients

Locations

325 S 1st Ave
Broken Bow, NE 68822
Phone (308) 872-5111

3811 Central Ave
Ste F
Kearney, NE 68847
Phone (308) 237-0591

3818 Normal Blvd
Lincoln, NE 68506
Phone (402) 488-4282

6319 Havelock Ave
Lincoln, NE 68507
Phone (402) 325-0044

1104 Grundman Blvd
Nebraska City, NE 68410
Phone (402) 873-7411

510 Bradford St
Ste B
Seward, NE 68434
Phone (402) 646-2007

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1518534783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 435",
            "city": "BROKEN BOW",
            "state": "NE",
            "postal_code": "688220435",
            "telephone_number": "308-872-5111",
            "fax_number": "308-872-5115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 CENTRAL AVE STE F",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688478173",
            "telephone_number": "308-237-0591",
            "fax_number": "308-237-4251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 S 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Broken Bow",
            "state": "NE",
            "postal_code": "688222213",
            "country_code": "US",
            "telephone_number": "308-872-5111",
            "fax_number": "308-872-5115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONOWSKI",
        "first_name": "DEREK",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "4206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.

Verify at the official NPI Registry.