Individual provider Active NPI

Lindsey Christel Mettenbrink, D.O.

  • Family Medicine Physician
  • Grand Island, NE
National Provider Identifier
1831504224
Registry record updated Feb 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1587 Issued in NE
Practice address
2444 W Faidley Ave
Grand Island, NE 68803-4327
Phone
(308) 382-1100
Fax
(308) 385-0782
NPI assigned
Jun 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1587 NE Primary

Addresses

Primary practice location

2444 W Faidley Ave
Grand Island, NE 68803-4327

Mailing address

2444 W Faidley Ave
Grand Island, NE 68803-4327
Phone (308) 382-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171002001366 NE Practitioner - Family Practice 8426277567 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Island Clinic IncGroup PAC ID 9931181526, 22 clinicians

Practice addresses (Care Compare)

2444 W Faidley Ave
Grand Island, NE 68803-4327
Phone (308) 382-1100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1587NEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Island Clinic Inc Family Medicine CurrentSince Nov 6, 2017 Accepting new patients
Grand Island Clinic Inc Past Accepting new patients

Locations

2444 W Faidley Ave
Grand Island, NE 68803
Phone (308) 382-1100

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550793600000",
    "number": "1831504224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2444 W FAIDLEY AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034327",
            "telephone_number": "308-382-1100",
            "fax_number": "308-385-0782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2444 W FAIDLEY AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034327",
            "telephone_number": "308-382-1100",
            "fax_number": "308-385-0782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METTENBRINK",
        "first_name": "LINDSEY",
        "middle_name": "CHRISTEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-24",
        "last_updated": "2019-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "1587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

Verify at the official NPI Registry.