Avera St Anthonys Hospital
Organization Active NPI Rural Health Clinic/Center · Spencer, NE
NPI 1629344692 · NPPES record last updated May 1, 2012
Key facts
- NPI
- 1629344692
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- AVERA ST ANTHONYS HOSPITAL
- Practice address
- 103 S Thayer St
Spencer, NE 68777-9784 - Phone
- (402) 589-1328
- NPI assigned
- Mar 23, 2012
- Organization subpart
- Yes
- Parent organization (as reported)
- AVERA ST ANTHONYS HOSPITAL
Authorized official
- Name
- Ronald J. Cork
- Title
- President/Ceo
- Phone
- (402) 336-2611
Parent organization (reported in NPPES) 1
Corporate family (same tax ID) 7
Practitioners 53
-
Jeffrey D Akerson, M.D.
-
Ryan Banks, M.D.
-
Dean L Benson, MPAC
-
Bradley Steven Bowdino, M.D.
-
Tara Callison, PA
-
David A Denman, MD
-
Chelsey M Dierks, PA-C
-
Terra J. Drueke, APRN
-
Alexis R. Erbst, M.D.
-
Brian J Finley, MD
-
Sara K. Frederick, PA-C
-
Muhammad Naser Imran, M.D.
-
Hannah M. Jessen, PA-C
-
Jenna M. Kaup, APRN
-
Kevin M Loecker, CRNA
-
Emily Christine Nolan, APRN-FNP-C
-
Anna Elizabeth Novak, APRN, FNP-C
-
Sarah Ongstad, MD
-
Heather A Pardun, APRN
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 28D2040591 | Avera Medical Group Spencer | Certificate of waiver | May 3, 2028 |
National Provider Directory
- Tax ID family
- St Anthonys Hosp Card Dep
- Part of
- St Anthonys Hosp Card Dep
Locations
209 E Benton St
Oneill, NE 68763
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
103 S Thayer St
Spencer, NE 68777-9784
Mailing address
PO Box 270
Oneill, NE 68763-0270
Phone (402) 336-2900
Other names
- Avera Medical Group Spencer
Other providers in Spencer, NE
- Boyd County Schools
- Highland House LLC
- Highland House LLC
- Jessen'S Family Dentistry and Dental Hygiene, P.C
- Niobrara Valley Hospital Corporation
All providers in Spencer, NE · Rural Health Clinic/Center in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.