Individual provider Active NPI

Randy Lynn Pomajzl, D.C.

  • Chiropractor
  • Grand Island, NE
National Provider Identifier
1558440339
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
870 Issued in NE
Practice address
3008 W Stolley Park Rd
Suite 3
Grand Island, NE 68801-7493
Phone
(308) 381-5554
Fax
(308) 382-0839
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 870 NE Primary

Addresses

Primary practice location

3008 W Stolley Park Rd
Suite 3
Grand Island, NE 68801-7493

Mailing address

3008 W Stolley Park Rd Ste 3
Grand Island, NE 68801-7492
Phone (308) 381-5554

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090706000369 NE Practitioner - Chiropractic 6002967940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pomajzl Chiropractic PCGroup PAC ID 7810048758, 2 clinicians

Practice addresses (Care Compare)

3008 W Stolley Park Rd
Grand Island, NE 68801-7492
Phone (308) 381-5554

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
870NEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pomajzl Chiropractic, P.C. Chiropractor CurrentSince Jul 7, 1985 Accepting new patients

Locations

3008 W Stolley Park Rd
Ste 3
Grand Island, NE 68801
Phone (308) 381-5554

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558440339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3008 W STOLLEY PARK RD STE 3",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688017492",
            "telephone_number": "308-381-5554",
            "fax_number": "308-382-0839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3008 W STOLLEY PARK RD",
            "address_2": "SUITE 3",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688017493",
            "telephone_number": "308-381-5554",
            "fax_number": "308-382-0839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POMAJZL",
        "first_name": "RANDY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.