NPIMap

Organization Active NPI

Pediatric Psychology Associates, PC

  • Psychologist
  • Beatrice, NE
National Provider Identifier
1801091988
Registry record updated Jan 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
PEDIATRIC PSYCHOLOGY ASSOCIATES, PC
Practice address
722 Court St Ste 103
Beatrice, NE 68310-3928
Phone
(402) 806-1700
Fax
(402) 228-2202
NPI assigned
Jun 18, 2007
Last updated
Jan 8, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2014

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

Authorized official

Name
Dr. Leland Carl Zlomke, PH.D.NPI 1164446605
Title
Ceo
Phone
(402) 806-1700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NE
Psychologist 103T00000X NE Primary

Addresses

Primary practice location

722 Court St Ste 103
Beatrice, NE 68310-3928

Mailing address

1400 Oak Street
Beatrice, NE 68310-4402
Phone (402) 806-1700

Other identifiers 1

IdentifierTypeStateIssuer
100257225-00MedicaidNE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389139200000",
    "number": "1801091988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 OAK STREET",
            "city": "BEATRICE",
            "state": "NE",
            "postal_code": "683104402",
            "telephone_number": "402-806-1700",
            "fax_number": "402-228-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 COURT ST STE 103",
            "city": "BEATRICE",
            "state": "NE",
            "postal_code": "683103928",
            "telephone_number": "402-806-1700",
            "fax_number": "402-228-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PSYCHOLOGY ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2014-01-08",
        "status": "A",
        "authorized_official_last_name": "ZLOMKE",
        "authorized_official_first_name": "LELAND",
        "authorized_official_middle_name": "CARL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "402-806-1700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NE",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100257225-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beatrice, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2014; 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.