NPIMap

Organization Active NPI

Roger W. Nutt, M.D.,P.C.

  • Medical Specialty Clinic/Center
  • Norfolk, NE
National Provider Identifier
1891914602
Registry record updated May 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
15072 Issued in AZ
Legal business name
ROGER W. NUTT, M.D.,P.C.
Practice address
710 S 13TH St
Suite 1200
Norfolk, NE 68701-5792
Phone
(402) 370-4570
NPI assigned
Apr 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2009

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

Authorized official

Name
Dr. Roger Wayne Nutt, M.D.NPI 1780689083
Title
President
Phone
(928) 344-4907

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 15072 AZ Primary

Addresses

Primary practice location

710 S 13TH St
Suite 1200
Norfolk, NE 68701-5792

Mailing address

710 S 13TH St
Suite 1200
Norfolk, NE 68701-5792
Phone (402) 370-4570

Other identifiers 1

IdentifierTypeStateIssuer
251778MedicaidAZ

National Provider Directory

National Provider Directory

Locations

2451 S Avenue A
Ste 20
Yuma, AZ 85364
Phone (928) 344-4907

710 S 13th St
Ste 1200
Norfolk, NE 68701
Phone (402) 370-4570

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242777600000",
    "number": "1891914602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 S 13TH ST",
            "address_2": "SUITE 1200",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687015792",
            "telephone_number": "402-370-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 S 13TH ST",
            "address_2": "SUITE 1200",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687015792",
            "telephone_number": "402-370-4570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGER W. NUTT, M.D.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2009-05-20",
        "status": "A",
        "authorized_official_last_name": "NUTT",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "928-344-4907",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "AZ",
            "license": "15072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251778",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.