NPIMap

Individual provider Active NPI

Jana G Van Wie, MD

  • Family Medicine Physician
  • Grand Island, NE
National Provider Identifier
1720062458
Registry record updated Mar 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
16706 Issued in NE
Practice address
3016 W Faidley Ave
Grand Island, NE 68803-4109
Phone
(308) 381-8546
Fax
(308) 381-8550
NPI assigned
Dec 6, 2005
Last updated
Mar 16, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2801-16706 NE
Family Medicine Physician 207Q00000X 16706 NE Primary

Addresses

Primary practice location

3016 W Faidley Ave
Grand Island, NE 68803-4109

Mailing address

3016 W Faidley Ave
Grand Island, NE 68803-4109
Phone (308) 382-8546

Other identifiers 10

IdentifierTypeStateIssuer
248833OtherNEMIDLANDS CHOICE
1033117015OtherNEGROUP NPI
P00885788OtherNERR MEDICARE
10025894200MedicaidNE
1669781225OtherNEGROUP NPI
097552OtherNEGROUP PTAN
097552008OtherNEPTAN
45359OtherNEBCBS
1720062458OtherNENPI
6501500001OtherNEMEDICARE DME PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060109000298 NE Practitioner - Family Practice 6608899356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nebraska College of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bryan Physician NetworkGroup PAC ID 7315915873, 236 clinicians

Practice addresses (Care Compare)

2300 S 16TH St
Bryan Medical Center
Lincoln, NE 68502-3704
Phone (402) 481-1111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2801-16706NEMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Bryan Physician Network Family Medicine CurrentSince Jul 24, 2023 Accepting new patients
Grand Island Clinic Inc Past Accepting new patients
Integrated Cardiology Group LLC PastSince Jul 1, 2022 Accepting new patients

Locations

3563 Prairieview St
Ste 200
Grand Island, NE 68803
Phone (308) 382-2010

3563 Prairieview St
Ste 200A
Grand Island, NE 68803

2222 S 16th St
Ste 400A
Lincoln, NE 68502
Phone (402) 475-8877

2300 S 16th St
Lincoln, NE 68502
Phone (402) 434-6042

Interoperability endpoints

  • Direct secure messaging: jvanwie57050@hisp.bryanhealth.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 7

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": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489622400000",
    "number": "1720062458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 W FAIDLEY AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034109",
            "telephone_number": "308-382-8546",
            "fax_number": "308-381-8546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3016 W FAIDLEY AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034109",
            "telephone_number": "308-381-8546",
            "fax_number": "308-381-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN WIE",
        "first_name": "JANA",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2017-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NE",
            "license": "2801-16706",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "16706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "248833",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1033117015",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00885788",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025894200",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1669781225",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "097552",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "097552008",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "45359",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1720062458",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME PTAN",
            "identifier": "6501500001",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

Verify at the official NPI Registry.