NPIMap

Organization Active NPI

Western Nebraska Urology LLC

  • Urology Physician
  • Scottsbluff, NE
National Provider Identifier
1720162993
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
22723 Issued in IL
Legal business name
WESTERN NEBRASKA UROLOGY LLC
Practice address
2 West 42ND Street
Suite 3600
Scottsbluff, NE 69361
Phone
(308) 630-2450
Fax
(308) 630-2492
NPI assigned
Oct 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Shawn Michael Acino, MD PACS
Title
President
Phone
(308) 630-2450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X 22723 IL Primary

Addresses

Primary practice location

2 West 42ND Street
Suite 3600
Scottsbluff, NE 69361

Mailing address

2 West 42ND Street
Suite 3600
Scottsbluff, NE 69361
Phone (308) 630-2450

Other identifiers 4

IdentifierTypeStateIssuer
241716OtherMIDLANDS CHOICE
DD6108OtherRR MCARE
07283OtherNEBLUE CROSS
10025264700MedicaidNE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720162993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WEST 42ND STREET",
            "address_2": "SUITE 3600",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "69361",
            "telephone_number": "308-630-2450",
            "fax_number": "308-630-2492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WEST 42ND STREET",
            "address_2": "SUITE 3600",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "69361",
            "telephone_number": "308-630-2450",
            "fax_number": "308-630-2492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN NEBRASKA UROLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ACINO",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "308-630-2450",
        "authorized_official_credential": "MD PACS"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "IL",
            "license": "22723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "241716",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCARE",
            "identifier": "DD6108",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "07283",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025264700",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsbluff, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.