Active NPI
Bryan D Bredthauer MD PC
- Orthopaedic Surgery Physician
- Omaha, NE
National Provider Identifier
1811067473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 17324
- Legal business name
- BRYAN D BREDTHAUER MD PC
- Practice address
- 11819 Miracle Hills Dr
Ste 203
Omaha, NE 68154-5308 - Phone
- (402) 492-9922
- Fax
- (402) 492-9944
- NPI assigned
- Nov 9, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bryan D Bredthauer, M.D.
- Title
- President
- Phone
- (402) 492-9922
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 17324 | NE | Primary |
Addresses
Primary practice location
11819 Miracle Hills Dr
Ste 203
Omaha, NE 68154-5308
Mailing address
11819 Miracle Hills Dr
Ste 203
Omaha, NE 68154-5308
Phone (402) 492-9922
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200023116 | Other | NE | RR MEDICARE |
| 261369 | Other | NE | MEDICARE GROUP PTAN |
| 00086 | Other | NE | BCBS NE |
| DQ4240 | Other | NE | RR MEDICARE GROUP PTAN |
National Provider Directory
National Provider DirectoryLocations
11819 Miracle Hills Dr
Ste 203
Omaha, NE 68154
Phone (402) 492-9922
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1284422400000",
"number": "1811067473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11819 MIRACLE HILLS DR",
"address_2": "STE 203",
"city": "OMAHA",
"state": "NE",
"postal_code": "681545308",
"telephone_number": "402-492-9922",
"fax_number": "402-492-9944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11819 MIRACLE HILLS DR",
"address_2": "STE 203",
"city": "OMAHA",
"state": "NE",
"postal_code": "681545308",
"telephone_number": "402-492-9922",
"fax_number": "402-492-9944"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRYAN D BREDTHAUER MD PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-09",
"last_updated": "2010-09-14",
"status": "A",
"authorized_official_last_name": "BREDTHAUER",
"authorized_official_first_name": "BRYAN",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "402-492-9922",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Orthopaedic Surgery",
"state": "NE",
"license": "17324",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "200023116",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP PTAN",
"identifier": "261369",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NE",
"identifier": "00086",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE GROUP PTAN",
"identifier": "DQ4240",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.