Scottsbluff Urology Assoc PC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

SCOTTSBLUFF UROLOGY ASSOC PC

Practice address

3911 Avenue B
2200
Scottsbluff, NE 69361-4617

Phone

(308) 632-5315

Fax

(308) 632-5261

NPI assigned

Jul 5, 2006

Organization subpart

No

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

Authorized official

Name

Dr. John N. Kabalin, M.D.NPI 1043302748

Title

President

Phone

(308) 632-5315

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Locations

Practitioners 1

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

• John N Kabalin, M.D.

  • Urology Physician
  • Scottsbluff, NE
  • NPI 1043302748
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412640000000",
    "number": "1780615401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3911 AVENUE B",
            "address_2": "2200",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693614617",
            "telephone_number": "308-632-5315",
            "fax_number": "308-632-5261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 AVENUE B",
            "address_2": "2200",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693614617",
            "telephone_number": "308-632-5315",
            "fax_number": "308-632-5261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTTSBLUFF UROLOGY ASSOC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2014-10-07",
        "status": "A",
        "authorized_official_last_name": "KABALIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "308-632-5315",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102713100",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Urology Physician in Scottsbluff, NE
• Providers in Scottsbluff, NE by specialty
• Urology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; 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.