Individual provider Active NPI

Callie L Haneborg, PA-C

  • Physician Assistant
  • North Platte, NE
National Provider Identifier
1801709274
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3506 Issued in NE
Practice address
500 W Leota St Ste 120
North Platte, NE 69101-6579
Phone
(308) 520-5425
NPI assigned
Sep 25, 2026
Last updated
Sep 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3506 NE Primary

Addresses

Primary practice location

500 W Leota St Ste 120
North Platte, NE 69101-6579

Mailing address

4317 Janice CT
North Platte, NE 69101-9707
Phone (308) 520-5425

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790294400000",
    "number": "1801709274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4317 JANICE CT",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691019707",
            "telephone_number": "308-520-5425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W LEOTA ST STE 120",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691016579",
            "telephone_number": "308-520-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANEBORG",
        "first_name": "CALLIE",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-25",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "3506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Platte, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.