NPIMap

Organization Active NPI

Wayne V Videtich DPM PC

  • Podiatric Clinic/Center
  • Lincoln, NE
National Provider Identifier
1922268234
Registry record updated Jun 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
License
NE134 Issued in NE
Legal business name
WAYNE V VIDETICH DPM PC
Practice address
2710 South St
Lincoln, NE 68502-3252
Phone
(402) 477-3200
Fax
(402) 477-3561
NPI assigned
Jun 10, 2008
Last updated
Jun 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2008

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

Authorized official

Name
Dr. Wayne V Videtich, DPMNPI 1013934074
Title
President
Phone
(402) 477-3200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X NE134 NE Primary

Addresses

Primary practice location

2710 South St
Lincoln, NE 68502-3252

Mailing address

2710 South St
Lincoln, NE 68502-3252
Phone (402) 477-3200

Other identifiers 3

IdentifierTypeStateIssuer
88434OtherNECOVENTRY
2545OtherNEBLUE CROSS/BLUE SHIELD
NE134OtherNEMUTUAL OF OMAHA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1922268234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 SOUTH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685023252",
            "telephone_number": "402-477-3200",
            "fax_number": "402-477-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 SOUTH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685023252",
            "telephone_number": "402-477-3200",
            "fax_number": "402-477-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE V VIDETICH DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-10",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "VIDETICH",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-477-3200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "NE",
            "license": "NE134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "88434",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "2545",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MUTUAL OF OMAHA",
            "identifier": "NE134",
            "state": "NE"
        }
    ],
    "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 Jun 10, 2008; 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.