NPIMap

Organization Active NPI

Tabitha, Inc.

Doing business as Tabitha Professional Services

  • General Practice Physician
  • Lincoln, NE
National Provider Identifier
1801971387
Registry record updated Oct 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
TABITHA, INC.
Doing business as
Tabitha Professional Services
Practice address
4720 Randolph Street
Lincoln, NE 68510-3741
Phone
(402) 483-7671
Fax
(402) 486-8539
NPI assigned
Oct 25, 2006
Last updated
Oct 8, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
TABITHA, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 8, 2013

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

Authorized official

Name
Mrs. Darcie L Brink
Title
Sr Vice President / Cfo
Phone
(402) 483-7671

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

4720 Randolph Street
Lincoln, NE 68510-3741

Mailing address

4720 Randolph Street
Lincoln, NE 68510-3741
Phone (402) 483-7671

Other names 1

  • Tabitha Professional Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050201000661 NE Part B Supplier - Clinic/Group Practice 3274421284 Receives reassigned benefits from 1 practitioner
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Franklin, NE; Holdrege, NE

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
Tabitha Health Care Ser10 organizations share this tax ID, including this one
Part of
Tabitha Health Care Ser

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381190400000",
    "number": "1801971387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 RANDOLPH STREET",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685103741",
            "telephone_number": "402-483-7671",
            "fax_number": "402-486-8539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 RANDOLPH STREET",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685103741",
            "telephone_number": "402-483-7671",
            "fax_number": "402-486-8539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TABITHA, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TABITHA, INC.",
        "enumeration_date": "2006-10-25",
        "last_updated": "2013-10-08",
        "status": "A",
        "authorized_official_last_name": "BRINK",
        "authorized_official_first_name": "DARCIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SR VICE PRESIDENT / CFO",
        "authorized_official_telephone_number": "402-483-7671",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tabitha Professional Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2013; 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.