Active NPI
Bluestem Health
- Federally Qualified Health Center (FQHC)
- Lincoln, NE
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- Legal business name
- BLUESTEM HEALTH
- Doing business as
- Bluestem Health 360
Bluestem Health Pediatrics - Practice address
- 2301 O St
Suite 2
Lincoln, NE 68510-1124 - Phone
- (402) 476-1455
- Fax
- (402) 476-1655
- NPI assigned
- Feb 22, 2016
- Organization subpart
- Yes
- Parent organization
- BLUESTEM HEALTH
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brad Lee Meyer
- Title
- Ceo
- Phone
- (402) 470-5424
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Family Medicine Physician | 207Q00000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Primary |
Addresses
Primary practice location
2301 O St
Suite 2
Lincoln, NE 68510-1124
Mailing address
1021 N 27TH St
Lincoln, NE 68503-1803
Phone (402) 476-1455
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10029301809 | Medicaid | NE | |
| 10026494202 | Medicaid | NE | |
| 10026494201 | Medicaid | NE |
Other names 2
- Bluestem Health 360
- Bluestem Health Pediatrics
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040219000213 | NE | Part B Supplier - Clinic/Group Practice | 6800706672 |
Receives reassigned benefits from 31 practitioners 7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lincoln, NE |
| O20160308001054 | NE | Part A Provider - Federally Qualified Health Center (FQHC) | 6800706672 | Practice locations: Lincoln, NE |
Federally qualified health center certification: CCN 281839
- Legal name
- BLUESTEM HEALTH
- Doing business as
- BLUESTEM HEALTH PEDIATRICS
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Mar 1, 2016
- Last certification
- Mar 1, 2016
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Enrollment address
- 2301 O St
Ste 2
Lincoln, NE 68510-1100
Other NPIs with the same Medicare PAC ID 3
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Other NPIs on the same Medicare enrollment 3
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 28D2088009 | Health 360 | Certificate of waiver | Dec 8, 2026 |
National Provider Directory
National Provider Directory- Tax ID family
- Bluestem Health
- Part of
- Bluestem Health
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Federally Qualified Health Center (FQHC)
- Lincoln, NE
- NPI 1770033912
Ownership & related parties
All disclosed owners & managing parties 2
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Jacque Fanning | Corporate Officer | Sep 6, 2016 | |
| W-2 Managing Employee | Sep 6, 2016 | ||
| Brad Meyer | Corporate Officer | Sep 15, 2014 | |
| W-2 Managing Employee | Sep 15, 2014 | ||
| Operational/Managerial Control | Sep 15, 2014 |
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physician Assistant
- Lincoln, NE
- NPI 1679347140
-
- Physician Assistant
- Lincoln, NE
- NPI 1083924617
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456099200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1767139200000",
"number": "1558720326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1021 N 27TH ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685031803",
"telephone_number": "402-476-1455",
"fax_number": "402-476-1655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 O ST",
"address_2": "SUITE 2",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685101124",
"telephone_number": "402-476-1455",
"fax_number": "402-476-1655"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BLUESTEM HEALTH",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "BLUESTEM HEALTH",
"enumeration_date": "2016-02-22",
"last_updated": "2025-12-31",
"certification_date": "2025-12-31",
"status": "A",
"authorized_official_last_name": "MEYER",
"authorized_official_first_name": "BRAD",
"authorized_official_middle_name": "LEE",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "402-470-5424"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10029301809",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10026494202",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10026494201",
"state": "NE"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Bluestem Health 360",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Bluestem Health Pediatrics",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.