Gothenburg Memorial Hospital
Organization Active NPI Family Medicine Physician · Brady, NE
NPI 1912445404 · NPPES record last updated Nov 13, 2025
Key facts
- NPI
- 1912445404
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- GOTHENBURG MEMORIAL HOSPITAL
- Practice address
- 114 N Main St
Brady, NE 69123-2749 - Phone
- (308) 584-3770
- NPI assigned
- Feb 6, 2017
- Organization subpart
- Yes
- Parent organization (as reported)
- GOTHENBURG MEMORIAL HOSPITAL
Authorized official
- Name
- Andrew D Knust
- Title
- Ceo
- Phone
- (308) 537-3661
Parent organization (reported in NPPES) 1
Other NPIs on the same Medicare enrollment 1
Practitioners 18
-
Brady Dutton Beecham, MD, MPH
-
Michael Paulus Crisman, PA-C
-
Anna Dalrymple, MD
-
Lacy J Dye, LIMHP
-
Sophia Rene Gomez, PA-C
-
Jordan Amber Haake, APRN
-
Kayla S Knauss, D.O.
-
Amanda Dawn Miller, APRN
-
Brady James O'Hare, M.D.
-
Aaron I Salomon, PAC
-
Garret T Shaw, MD
-
Irfan A Vaziri, MD, MBBS
-
Michelle K Chew, NP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050330001110 | NE | Part B Supplier - Clinic/Group Practice | 6709832983 |
Receives reassigned benefits from 21 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Gothenburg, NE |
National Provider Directory
- Part of
- Gothenburg Mem Hospital
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
114 N Main St
Brady, NE 69123-2749
Mailing address
PO Box 469
Gothenburg, NE 69138-0469
Phone (308) 537-3661
Other names
- Brady Clinic
Other providers in Brady, NE
- Brady Public Schools
- Brady Rural Health Clinic PC
- Brady Volunteer Fire Department
- Sara Marie Gentry
- Graceful Warrior Counseling and Consulting LLC
- Jodi Nelan LCSW Lac
- Ingrid Yvette King
- Millenia I Lee
- Ashley Lydic
All providers in Brady, NE · Family Medicine Physician in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.