Individual provider Active NPI

Raeann T Meyer, PA

  • Physician Assistant
  • Fremont, NE
National Provider Identifier
1679658058
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1308 Issued in NE
Practice address
350 W 23Rd St
Fremont, NE 68025-2592
Phone
(402) 721-5727
NPI assigned
Oct 26, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1308 NE Primary

Addresses

Primary practice location

350 W 23Rd St
Fremont, NE 68025-2592

Mailing address

350 W 23Rd St
Fremont, NE 68025-2592
Phone (402) 721-5727

Other practice location 1

812 N 22nd St
Blair, NE 68008-1128
Phone (402) 426-4611

Other practice location 2

812 N 22nd St
Blair, NE 68008-1128
Phone (402) 426-4611

Other identifiers 2

IdentifierTypeStateIssuer
P00610473OtherNERR MEDICARE
4708191541MedicaidNE

Other names 1

  • Raeann T Kirchoffner Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070412000419 NE Practitioner - Physician Assistant 7618072083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians

Practice addresses (Care Compare)

10060 Regency Cir
Omaha, NE 68114-3732
Phone (402) 354-1570

350 W 23Rd St
Prairie Fields MPC
Fremont, NE 68025-2592
Phone (402) 721-7077

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1308NEMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Methodist Hospital Current Accepting new patients
Physicians Clinic Inc Physician Assistant CurrentSince Aug 15, 2020 Accepting new patients
Milo V. Anderson M.D. Past Accepting new patients

Locations

810 N 22nd St
Blair, NE 68008
Phone (402) 426-1116

812 N 22nd St
Blair, NE 68008
Phone (402) 426-4611

2540 N Healthy Way
Fremont, NE 68025
Phone (402) 721-3133

350 W 23rd St
Fremont, NE 68025
Phone (402) 721-2444

350 W 23rd St
Ste D
Fremont, NE 68025
Phone (402) 721-8800

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

825 S 169th St
Omaha, NE 68118
Phone (402) 354-3370

Interoperability endpoints

  • Direct secure messaging: raeann.meyer@direct.nmhs.org

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1679658058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 W 23RD ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252592",
            "telephone_number": "402-721-5727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W 23RD ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252592",
            "telephone_number": "402-721-5727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "812 N 22nd St",
            "address_purpose": "LOCATION",
            "city": "Blair",
            "state": "NE",
            "postal_code": "680081128",
            "country_code": "US",
            "telephone_number": "402-426-4611",
            "fax_number": "402-426-4642",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "812 N 22nd St",
            "address_purpose": "LOCATION",
            "city": "Blair",
            "state": "NE",
            "postal_code": "680081128",
            "country_code": "US",
            "telephone_number": "402-426-4611",
            "fax_number": "402-426-4642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEYER",
        "first_name": "RAEANN",
        "middle_name": "T",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00610473",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4708191541",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAEANN",
            "last_name": "KIRCHOFFNER",
            "middle_name": "T",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fremont, NE

Sources for this page

Verify at the official NPI Registry.