NPIMap

Organization Active NPI

Perkins County Hospital District

Doing business as Grant Medical Clinic

  • Critical Access Hospital Clinic/Center
  • Grant, NE
National Provider Identifier
1720095755
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access Hospital Clinic/CenterTaxonomy code 261QC0050X
License
4142 Issued in NE
Legal business name
PERKINS COUNTY HOSPITAL DISTRICT
Doing business as
Grant Medical Clinic
Practice address
912 Central Ave
Grant, NE 69140-3099
Phone
(308) 352-7100
Fax
(308) 352-7103
NPI assigned
Aug 2, 2006
Last updated
Jul 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Authorized official

Name
James Lebrun
Title
Ceo
Phone
(308) 352-7200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital Clinic/Center 261QC0050X 4142 NE Primary

Addresses

Primary practice location

912 Central Ave
Grant, NE 69140-3099

Mailing address

900 Lincoln Ave
Grant, NE 69140-3095
Phone (308) 352-7100

Other names 1

  • Grant Medical Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041007000699 NE Part B Supplier - Clinic/Group Practice 0840109823 Receives reassigned benefits from 29 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ogallala, NE; Grant, NE

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory

Locations

900 Lincoln Ave
Grant, NE 69140
Phone (308) 284-8421

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374019200000",
    "number": "1720095755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 LINCOLN AVE",
            "city": "GRANT",
            "state": "NE",
            "postal_code": "691403095",
            "telephone_number": "308-352-7100",
            "fax_number": "308-352-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 CENTRAL AVE",
            "city": "GRANT",
            "state": "NE",
            "postal_code": "691403099",
            "telephone_number": "308-352-7100",
            "fax_number": "308-352-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERKINS COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2013-07-17",
        "status": "A",
        "authorized_official_last_name": "LEBRUN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "308-352-7200"
    },
    "taxonomies": [
        {
            "code": "261QC0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Critical Access Hospital",
            "state": "NE",
            "license": "4142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grant Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grant, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.