NPIMap

Organization Active NPI

Bryan Medical Center

Doing business as Bryan Medical Center Laboratory

  • Clinical Medical Laboratory
  • Lincoln, NE
National Provider Identifier
1689203077
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
BRYAN MEDICAL CENTER
Doing business as
Bryan Medical Center Laboratory
Practice address
2221 S 17TH St
Ste 100
Lincoln, NE 68502-3763
Phone
(402) 481-5920
NPI assigned
Apr 7, 2020
Last updated
May 7, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
BRYAN MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 7, 2026

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

Authorized official

Name
Michael Johnston
Title
President/Ceo
Phone
(402) 481-1111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

2221 S 17TH St
Ste 100
Lincoln, NE 68502-3763

Mailing address

1600 S 48TH St
Lincoln, NE 68506-1283
Phone (402) 481-3548

Other names 1

  • Bryan Medical Center Laboratory Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@hisp.bryanhealth.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100923001171 NE Part A Provider - Hospital 4284628652 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lincoln, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689203077. Details of each certification follow.

Hospital certification: CCN 280003

Legal name
BRYAN MEDICAL CENTER
Doing business as
BRYAN MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Aug 13, 2009
Beds
630 (503 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Dec 17, 1920 in NE
Enrollment address
1600 S 48TH St
Lincoln, NE 68506-1299
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Bryan Medical CenterCCN 280003 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

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
28D0679424Bryan Medical Center - West Campus2221 South 17TH Street, Suite 100, Lincoln, NE 68502AccreditationFeb 27, 2027
28D0944177Pathology Medical Services PC2221 South 17TH Street, Suite 100, Lincoln, NE 68502AccreditationJul 18, 2027

National Provider Directory

National Provider Directory
Tax ID family
BMH Professional Billin13 organizations share this tax ID, including this one
Part of
BMH Professional Billin

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 22

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Max L Rodenburg Individual Corporate Director Jan 1, 2021
Pablo Cervantes Individual Corporate Director Jan 1, 2019
Janet C Chung Individual Corporate Director Jan 1, 2019
Michaella J Kumke Individual Corporate Director Jan 1, 2024
Erin C Pemberton Duggan Individual Corporate Officer Jan 1, 2021
Corporate Director Jan 1, 2020
Lorenzo a Ball Individual Corporate Director Jan 1, 2023
Krystal L Siebrandt Individual Corporate Director Jan 1, 2024
Kenneth P Gross Individual Corporate Officer Jan 1, 2022
Corporate Director Jan 1, 2018
Bryan Health Organization, Lincoln, NE Corporation, Non-profit Operational/Managerial Control Oct 4, 1985
Jack J Huck Individual Corporate Officer Jan 1, 2020
Corporate Director Jan 1, 2018
William M Johnson Individual Corporate Director Jan 1, 2020
Elizabeth W Lau Individual Corporate Director Jan 1, 2022
Robert a Oakes Individual Corporate Director Jan 1, 2022
Eric N Mooss Individual Contracted Managing EmployeePresident/Ceo Jan 1, 2023
Corporate OfficerPresident/Ceo Jan 1, 2023
Corporate DirectorPresident/Ceo Jan 1, 2023
Operational/Managerial ControlPresident/Ceo Jan 1, 2023
Shannon R Harner Individual Corporate Director Jan 1, 2016
Alissa M Clough Individual Corporate Director Jan 1, 2024
David G Griffiths Individual W-2 Managing EmployeeCfo Jan 1, 2023
Operational/Managerial ControlCfo Jan 1, 2023
Aina I Silenieks Individual Corporate Director Jan 1, 2024
Russell R Gronewold Individual Contracted Managing Employee Dec 29, 2009
Corporate Officer Jan 3, 2020
Corporate Director Jan 3, 2020
Operational/Managerial Control Dec 29, 2009
Gayle Page Individual Corporate Director Jan 1, 2021
Connie S Edmond Individual Corporate Officer Jan 1, 2024
Corporate Director Jan 1, 2022
Lisa M Newcomer Vail Individual Corporate Director Nov 2, 2023

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 1,119

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,119

NPI Registry JSON

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

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778112000000",
    "number": "1689203077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S 48TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685061283",
            "telephone_number": "402-481-3548",
            "fax_number": "402-481-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 S 17TH ST",
            "address_2": "STE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685023763",
            "telephone_number": "402-481-5920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRYAN MEDICAL CENTER",
        "enumeration_date": "2020-04-07",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "402-481-1111"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@hisp.bryanhealth.org",
            "affiliation": "N",
            "address_1": "1600 S 48th St",
            "city": "Lincoln",
            "state": "NE",
            "country_code": "US",
            "postal_code": "685061299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Bryan Medical Center Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.