NPIMap

Organization Active NPI

Columbus Community Hospital Inc

Doing business as Columbus Dermatology Clinic

  • Dermatology Physician
  • Columbus, NE
National Provider Identifier
1881370476
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
COLUMBUS COMMUNITY HOSPITAL INC
Doing business as
Columbus Dermatology Clinic
Practice address
4508 38TH St Ste 210
Columbus, NE 68601-1668
Phone
(402) 562-4760
NPI assigned
Jun 27, 2023
Last updated
Sep 7, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
COLUMBUS COMMUNITY HOSPITAL INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Authorized official

Name
Chad E Van Cleave
Title
Vice President Finance
Phone
(402) 562-3357

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X Primary

Addresses

Primary practice location

4508 38TH St Ste 210
Columbus, NE 68601-1668

Mailing address

PO Box 1800
Columbus, NE 68602-1800
Phone (402) 564-7118

Other names 1

  • Columbus Dermatology Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120508000181 NE Part B Supplier - Clinic/Group Practice 7517954944 Receives reassigned benefits from 81 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: York, NE; Pender, NE; Papillion, NE; Orchard, NE; Omaha, NE; Columbus, NE; Norfolk, NE; Neligh, NE…

Other NPIs on the same Medicare enrollment 8

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
28D2287906Columbus Dermatology Clinic4508 38TH Street #210 & #170, Columbus, NE 68601ComplianceMar 13, 2028

National Provider Directory

National Provider Directory
Tax ID family
Columbus Community Hospital6 organizations share this tax ID, including this one
Part of
Columbus Community Hospital

Other organizations with this tax ID 5

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

Locations

1454 28th Ave
Columbus, NE 68601
Phone (402) 564-2816

2108 13th St
Columbus, NE 68601
Phone (402) 562-3341

3005 19th St
Columbus, NE 68601
Phone (402) 562-3341

3005 19th St
Ste 200
Columbus, NE 68601
Phone (402) 562-3341

3005 19th St
Ste 300
Columbus, NE 68601
Phone (402) 562-4480

3100 23rd St
#30
Columbus, NE 68601
Phone (402) 562-7346

3100 23rd St
Ste 1
Columbus, NE 68601
Phone (402) 562-5400

3100 23rd St
Ste 15
Columbus, NE 68601
Phone (402) 562-4607

3764 39th Ave
Columbus, NE 68601
Phone (402) 562-8666

3912 38th St
Ste A
Columbus, NE 68601
Phone (402) 562-3333

3912 38th St
Ste D
Columbus, NE 68601
Phone (402) 562-7346

4508 38th St
Ste 115
Columbus, NE 68601
Phone (402) 562-4730

4508 38th St
Ste 168
Columbus, NE 68601
Phone (402) 562-4477

4508 38th St
Ste 2100
Columbus, NE 68601

4508 38th St
Ste 250
Columbus, NE 68601
Phone (402) 564-5333

336 S 9th St
David City, NE 68632
Phone (402) 367-3193

2560 N Healthy Way
Fremont, NE 68025
Phone (402) 727-5863

2221 S 17th St
Ste 202
Lincoln, NE 68502
Phone (402) 476-6626

2222 N Lincoln Ave
York, NE 68467
Phone (402) 362-0420

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 158

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 158

NPI Registry JSON

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1881370476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1800",
            "city": "COLUMBUS",
            "state": "NE",
            "postal_code": "686021800",
            "telephone_number": "402-564-7118",
            "fax_number": "402-562-3378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4508 38TH ST STE 210",
            "city": "COLUMBUS",
            "state": "NE",
            "postal_code": "686011668",
            "telephone_number": "402-562-4760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBUS COMMUNITY HOSPITAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLUMBUS COMMUNITY HOSPITAL INC",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "VAN CLEAVE",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VICE PRESIDENT FINANCE",
        "authorized_official_telephone_number": "402-562-3357"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Columbus Dermatology Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Columbus Dermatology Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.