NPIMap

Organization Active NPI

Bluestem Health

  • Federally Qualified Health Center (FQHC)
  • Lincoln, NE
National Provider Identifier
1770033912
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BLUESTEM HEALTH
Doing business as
Bluestem Health Thompson Clinic
Thompson Clinic
Practice address
2222 S 16TH St
Ste 435
Lincoln, NE 68502-3796
Phone
(402) 474-7445
Fax
(402) 476-1670
NPI assigned
Oct 12, 2016
Organization subpart
Yes
Parent organization
BLUESTEM HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Authorized official

Name
Brad Lee Meyer
Title
Ceo
Phone
(402) 470-5424

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

2222 S 16TH St
Ste 435
Lincoln, NE 68502-3796

Mailing address

1021 N 27TH St
Lincoln, NE 68503-1803
Phone (402) 476-1455

Other identifiers 2

IdentifierTypeStateIssuer
10026494205MedicaidNE
10026494204MedicaidNE

Other names 2

  • Bluestem Health Thompson Clinic Doing business as
  • Thompson Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040219000213 NE Part B Supplier - Clinic/Group Practice 6800706672 Receives reassigned benefits from 31 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lincoln, NE
O20161107002252 NE Part A Provider - Federally Qualified Health Center (FQHC) 6800706672 Practice locations: Lincoln, NE

Federally qualified health center certification: CCN 281841

Legal name
BLUESTEM HEALTH
Doing business as
THOMPSON CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 7, 2016
Last certification
Nov 7, 2016
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Aug 21, 2002 in NE
Enrollment address
2222 S 16TH St
Ste 435
Lincoln, NE 68502-3793

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

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

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
28D0454943Bluestem Health Thompson Clinic2222 S 16TH Street, Ste 435, Lincoln, NE 68502Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Bluestem Health2 organizations share this tax ID, including this one
Part of
Bluestem Health

Other organizations with this tax ID 1

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

Locations

1021 N 27th St
Lincoln, NE 68503
Phone (402) 476-1640

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Jacque Fanning Individual Corporate OfficerCfo Sep 6, 2016
W-2 Managing EmployeeCfo Sep 6, 2016
Brad Meyer Individual Corporate OfficerCeo Sep 15, 2014
W-2 Managing EmployeeCeo Sep 15, 2014
Operational/Managerial ControlCeo Sep 15, 2014

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1770033912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 N 27TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685031803",
            "telephone_number": "402-476-1455",
            "fax_number": "402-476-1670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 S 16TH ST",
            "address_2": "STE 435",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685023796",
            "telephone_number": "402-474-7445",
            "fax_number": "402-476-1670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUESTEM HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLUESTEM HEALTH",
        "enumeration_date": "2016-10-12",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "402-470-5424"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026494205",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026494204",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bluestem Health Thompson Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Thompson Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Thompson Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.