NPIMap

Organization Active NPI

The Mary Lanning Memorial Hospital Association

Doing business as Sutton Medical Clinic

  • Family Medicine Physician
  • Sutton, NE
National Provider Identifier
1528175247
Registry record updated Sep 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION
Doing business as
Sutton Medical Clinic
Practice address
301 S Way Ave
Sutton, NE 68979-2134
Phone
(402) 773-5553
Fax
(402) 773-5554
NPI assigned
Aug 25, 2006
Last updated
Sep 12, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 12, 2013

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

Authorized official

Name
Mr. Eric A Barber
Title
Ceo
Phone
(402) 461-5108

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Family Nurse Practitioner 363LF0000X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

301 S Way Ave
Sutton, NE 68979-2134

Mailing address

715 N Saint Joseph Ave
Hastings, NE 68901-4497
Phone (402) 463-4521

Other identifiers 1

IdentifierTypeStateIssuer
10025431200MedicaidNE

Other names 1

  • Sutton Medical Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031105000492 NE Part B Supplier - Clinic/Group Practice 4587575550 Receives reassigned benefits from 51 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Henderson, NE; Holdrege, NE; Kenesaw, NE; Lexington, NE; Lincoln, NE; McCook, NE; Minden, NE; North Platte, NE…

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
The Mary Lanning Memorial Hospital a

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378944000000",
    "number": "1528175247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 N SAINT JOSEPH AVE",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689014497",
            "telephone_number": "402-463-4521",
            "fax_number": "402-461-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S WAY AVE",
            "city": "SUTTON",
            "state": "NE",
            "postal_code": "689792134",
            "telephone_number": "402-773-5553",
            "fax_number": "402-773-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION",
        "enumeration_date": "2006-08-25",
        "last_updated": "2013-09-12",
        "status": "A",
        "authorized_official_last_name": "BARBER",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "402-461-5108",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025431200",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sutton Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sutton, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; 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.