Individual provider Active NPI

Andrew Corbin

  • Psychiatric/Mental Health Nurse Practitioner
  • Lincoln, NE
National Provider Identifier
1871078501
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
112635 Issued in NE
Practice address
801 W Prospector PL
Lincoln, NE 68522-1970
Phone
(402) 318-2461
NPI assigned
Sep 27, 2018
Last updated
Sep 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 112635 NE Primary

Addresses

Primary practice location

801 W Prospector PL
Lincoln, NE 68522-1970

Mailing address

5610 Bancroft Ave
Lincoln, NE 68506-4516
Phone (402) 525-4649

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190115003388 NE Practitioner - Nurse Practitioner 4587900345 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Genesis Psychiatric Group LLCGroup PAC ID 3779808571, 6 clinicians

Practice addresses (Care Compare)

2130 S 17TH St
Suite 100
Lincoln, NE 68502-3750
Phone (402) 454-7454

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
State of Nebraska Dept of Admin Services CurrentSince Dec 14, 2018 Accepting new patients
Genesis Psychiatric Group, LLC Psychiatric/Mental Health CurrentSince Oct 4, 2022 Accepting new patients
State of Nebraska Dept of Admin Services Current Accepting new patients
State of Nebraska Dept of Admin Services CurrentSince Dec 14, 2018 Accepting new patients

Locations

2130 S 17th St
Ste 100
Lincoln, NE 68502
Phone (402) 454-7454

2450 Q St
Lincoln, NE 68503
Phone (402) 454-7454

801 W Prospector Pl
Lincoln, NE 68522
Phone (402) 471-2654

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1538006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1871078501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5610 BANCROFT AVE",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685064516",
            "telephone_number": "402-525-4649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W PROSPECTOR PL",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685221970",
            "telephone_number": "402-318-2461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORBIN",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-27",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NE",
            "license": "112635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.