Organization Active NPI

Lincoln Internal Medicine Associates, PC

  • Internal Medicine Physician
  • Lincoln, NE
National Provider Identifier
1891708848
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LINCOLN INTERNAL MEDICINE ASSOCIATES, PC
Practice address
3901 Pine Lake Rd
Suite 220
Lincoln, NE 68516-5497
Phone
(402) 421-3240
Fax
(402) 423-0739
NPI assigned
Aug 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Authorized official

Name
Morgan Ariel Schrunk
Title
Credentialing Coordinator
Phone
(531) 218-0500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

3901 Pine Lake Rd
Suite 220
Lincoln, NE 68516-5497

Mailing address

3901 Pine Lake Rd
Suite 220
Lincoln, NE 68516-5497
Phone (402) 421-3240

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040816001222 NE Part B Supplier - Clinic/Group Practice 1658344825 Receives reassigned benefits from 13 practitioners
Practice locations: Lincoln, NE

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
28D0934062Lincoln Internal Medicine Associates3901 Pine Lake Rd, Ste 220, Lincoln, NE 68516AccreditationMay 3, 2027

National Provider Directory

National Provider Directory

Locations

2222 S 16th St
#A300
Lincoln, NE 68502
Phone (402) 475-4295

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14572/brand/3/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679529600000",
    "number": "1891708848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 PINE LAKE RD",
            "address_2": "SUITE 220",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685165497",
            "telephone_number": "402-421-3240",
            "fax_number": "402-423-0739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 PINE LAKE RD",
            "address_2": "SUITE 220",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685165497",
            "telephone_number": "402-421-3240",
            "fax_number": "402-423-0739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN INTERNAL MEDICINE ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "SCHRUNK",
        "authorized_official_first_name": "MORGAN",
        "authorized_official_middle_name": "ARIEL",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "531-218-0500"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.