NPIMap

Individual provider Active NPI

Julie A Lindstrom, D.O.

  • Family Medicine Physician
  • Broken Bow, NE
National Provider Identifier
1528098407
Registry record updated Aug 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
257 Issued in NE
Practice address
145 Memorial Dr
Broken Bow, NE 68822-1378
Phone
(308) 872-2486
Fax
(308) 872-2027
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 257 NE Primary

Addresses

Primary practice location

145 Memorial Dr
Broken Bow, NE 68822-1378

Mailing address

145 Memorial Dr
Broken Bow, NE 68822-1378
Phone (308) 872-2486

Other identifiers 2

IdentifierTypeStateIssuer
03224OtherNEBCBS
12327OtherNEMIDLAND'S CHOICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040421000245 NE Practitioner - Family Practice 6507852118 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1998
Medicare assignment
May accept Medicare assignment
Group practices
Central Nebraska Medical Clinic PC 8 clinicians
Jennie M Melham Memorial Medical Center Inc 8 clinicians

Practice addresses (Care Compare)

145 Memorial Dr
Broken Bow, NE 68822-1378
Phone (308) 872-2486

Hospital & facility affiliations

  • VCHS Home Health Home health agency, Ord, NE, CCN 287055
  • Aseracare Hospice Hospice, Kearney, NE, CCN 281543
  • Brookestone Home Health & Hospice Hospice, Kearney, NE, CCN 281533
  • Jennie M Melham Memorial Medical Center Hospital, Broken Bow, NE, CCN 281365
  • Valley County Health System Hospital, Ord, NE, CCN 281353
  • CHI Health Good Samaritan Hospital, Kearney, NE, CCN 280009
  • Brookestone View Nursing home, Broken Bow, NE, CCN 285297
  • Jennie M Melham Memorial Medical Center Nursing home, CCN 28Z365

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions21
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
257NEMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Jennie M Melham Memorial Medical Center Inc Current Accepting new patients
Jennie M Melham Memorial Medical Center Inc CurrentSince Sep 15, 2018 Accepting new patients
Central Nebraska Medical Clinic PC Family Medicine CurrentSince Sep 1, 2011 Accepting new patients
VSL Broken Bow LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: julie.lindstrom@cnmcpc.eclinicaldirectplus.com

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Brookestone ViewBroken Bow, NE, CCN 285297 Skilled nursing facility Contracted Managing Employee
Operational/Managerial Control		 Jul 1, 2017
Jul 1, 2017

Owned or controlled facilities with NPI records 1

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

Organizations & group practices 5

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314576000000",
    "number": "1528098407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 MEMORIAL DR",
            "city": "BROKEN BOW",
            "state": "NE",
            "postal_code": "688221378",
            "telephone_number": "308-872-2486",
            "fax_number": "308-872-2027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 MEMORIAL DR",
            "city": "BROKEN BOW",
            "state": "NE",
            "postal_code": "688221378",
            "telephone_number": "308-872-2486",
            "fax_number": "308-872-2027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDSTROM",
        "first_name": "JULIE",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2011-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "03224",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLAND'S CHOICE",
            "identifier": "12327",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Bow, NE

Sources for this page

Verify at the official NPI Registry.