Individual provider Active NPI

Jeremiah Fleenor, MD

  • Emergency Medicine Physician
  • Norfolk, NE
National Provider Identifier
1750538575
Registry record updated Jul 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
27327 Issued in NE
Practice address
2700 W Norfolk Ave
Norfolk, NE 68701-4438
Phone
(402) 644-8121
NPI assigned
Aug 22, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 125052263 IL
Emergency Medicine Physician 207P00000X 48533 CO
Emergency Medicine Physician 207P00000X 27327 NE Primary

Addresses

Primary practice location

2700 W Norfolk Ave
Norfolk, NE 68701-4438

Mailing address

2700 W Norfolk Ave
Norfolk, NE 68701-4438
Phone (402) 644-8121

Other identifiers 2

IdentifierTypeStateIssuer
93282052MedicaidCO
020827OtherCOKAISER COMMERICAL NUMBER

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130917000644 NE Practitioner - Emergency Medicine 5395930929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Colorado School of Medicine, Denver, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Faith Regional Physician Services LLCGroup PAC ID 5193786168, 194 clinicians

Practice addresses (Care Compare)

2700 W Norfolk Ave
Faith Regional Health Services
Norfolk, NE 68701-4438
Phone (402) 371-4880

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.77 of 100Reported as group
Quality
67.03
Promoting interoperability
96
Improvement activities
40
Cost
72.22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48533COMDEmergency Medicine Physician
125052263ILMDEmergency Medicine Physician
27327NEMDEmergency Medicine Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1219363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406592000000",
    "number": "1750538575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 W NORFOLK AVE",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687014438",
            "telephone_number": "402-644-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 W NORFOLK AVE",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687014438",
            "telephone_number": "402-644-8121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEENOR",
        "first_name": "JEREMIAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-22",
        "last_updated": "2014-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125052263",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "48533",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NE",
            "license": "27327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "93282052",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERICAL NUMBER",
            "identifier": "020827",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, NE

Sources for this page

Verify at the official NPI Registry.