Sacred Heart Rural Health Clinics

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

SACRED HEART RURAL HEALTH CLINICS

Doing business as

Avera Medical Group Niobrara

Practice address

25410 Park Ave
Apartment E
Niobrara, NE 68760-7044

Phone

(402) 857-3398

Fax

(402) 857-3315

NPI assigned

Oct 2, 2006

Last updated

Feb 7, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Pam Rezac

Title

President/Ceo

Phone

(605) 668-8322

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Avera Medical Group Niobrara Doing business as

Locations

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328572800000",
    "number": "1801989967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W 4TH ST",
            "address_2": "SUITE 8",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570783730",
            "telephone_number": "605-655-1201",
            "fax_number": "605-655-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25410 PARK AVE",
            "address_2": "APARTMENT E",
            "city": "NIOBRARA",
            "state": "NE",
            "postal_code": "687607044",
            "telephone_number": "402-857-3398",
            "fax_number": "402-857-3315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED HEART RURAL HEALTH CLINICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2012-02-07",
        "status": "A",
        "authorized_official_last_name": "REZAC",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "605-668-8322",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "921087",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025008100",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera Medical Group Niobrara",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amy Pinkelman, RN
• Stephani Sue Reinhardt, RN
• Teresa Remick, MSW, CSW, LMHP
• Julie M Reynolds
• Sacred Heart Health Services (Avera Niobrara Clinic)
• Danielle Sheree Sage
• Joann Rosa Sahagun
• Jonathan Sahagun, MICP
• Felicia Jean Sailer, RN
• Tamara Ann Sandoval, EMT -B

• Rural Health Clinic/Center in Niobrara, NE
• Providers in Niobrara, NE by specialty
• Rural Health Clinic/Center in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; 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.