Individual provider Active NPI

Andrew Donald Miner

  • Physical Therapist
  • Nebraska City, NE
National Provider Identifier
1548515919
Registry record updated Dec 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
NE3106 Issued in NE
Practice address
1104 Grundman Blvd
Nebraska City, NE 68410-3397
Phone
(402) 873-7411
NPI assigned
Jul 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2012

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 NE3106 NE Primary

Addresses

Primary practice location

1104 Grundman Blvd
Nebraska City, NE 68410-3397

Mailing address

2030 Rainbow Ave
Seward, NE 68434-3000
Phone (402) 643-0711

Other identifiers 1

IdentifierTypeStateIssuer
NA1822004OtherNEMEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121105000148 NE Practitioner - Physical Therapist in Private Practice 8527219377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nebraska City Physical Therapy LLCGroup PAC ID 4486836301, 12 clinicians

Practice addresses (Care Compare)

510 Bradford St
Suite B
Seward, NE 68434-1709
Phone (402) 646-2007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3106NEMDGeneral Practice Physician
NE3106NEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska City Physical Therapy, LLC Physical Therapist CurrentSince Jul 23, 2012 Accepting new patients

Locations

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

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

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 1

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": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356566400000",
    "number": "1548515919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 RAINBOW AVE",
            "city": "SEWARD",
            "state": "NE",
            "postal_code": "684343000",
            "telephone_number": "402-643-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 GRUNDMAN BLVD",
            "city": "NEBRASKA CITY",
            "state": "NE",
            "postal_code": "684103397",
            "telephone_number": "402-873-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINER",
        "first_name": "ANDREW",
        "middle_name": "DONALD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-20",
        "last_updated": "2012-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "NE3106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "NA1822004",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nebraska City, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.