NPIMap

Organization Active NPI

Regenirex, LLC

  • Pain Medicine (Anesthesiology) Physician
  • Kearney, NE
National Provider Identifier
1669827614
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
22010 Issued in NE
Legal business name
REGENIREX, LLC
Practice address
5205 2ND Ave Ste 1
Kearney, NE 68847-2471
Phone
(308) 237-9696
Fax
(308) 237-4517
NPI assigned
Apr 27, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Authorized official

Name
Dr. Burt J. McKeag, M.D.NPI 1376651729
Title
Owner
Phone
(308) 224-3723

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X 22010 NE Primary

Addresses

Primary practice location

5205 2ND Ave Ste 1
Kearney, NE 68847-2471

Mailing address

4620 Dove Hill Ave
Kearney, NE 68845-0639
Phone (308) 224-3723

Other identifiers 1

IdentifierTypeStateIssuer
10025124701MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040603000320 NE Part B Supplier - Clinic/Group Practice 4385626332 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
Practice locations: Kearney, NE

Other NPIs on the same Medicare enrollment 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
28D2119127Regenirex, LLC5205 2ND Ave, Ste 1, Kearney, NE 68847Certificate of waiverSep 19, 2026

National Provider Directory

National Provider Directory

Locations

5205 2nd Ave
Ste 1
Kearney, NE 68847
Phone (308) 237-9696

920 E 56th St
Ste D
Kearney, NE 68847
Phone (308) 236-7471

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14130/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644883200000",
    "number": "1669827614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4620 DOVE HILL AVE",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688450639",
            "telephone_number": "308-224-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5205 2ND AVE STE 1",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688472471",
            "telephone_number": "308-237-9696",
            "fax_number": "308-237-4517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENIREX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-27",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A",
        "authorized_official_last_name": "MCKEAG",
        "authorized_official_first_name": "BURT",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "308-224-3723",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NE",
            "license": "22010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025124701",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; 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.