Complete Family Care LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

110175 Issued in NE

Legal business name

COMPLETE FAMILY CARE LLC

Practice address

908 N Howard Ave
Suite 108
Grand Island, NE 68803-3556

Phone

(308) 675-1931

NPI assigned

Dec 18, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Malcolm Leal Castaneda

Title

Manager

Phone

(308) 675-1931

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1450396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450396800000",
    "number": "1922463926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 N HOWARD AVE",
            "address_2": "SUITE 108",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688033556",
            "telephone_number": "308-675-1931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 N HOWARD AVE",
            "address_2": "SUITE 108",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688033556",
            "telephone_number": "308-675-1931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE FAMILY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-18",
        "last_updated": "2015-12-18",
        "status": "A",
        "authorized_official_last_name": "CASTANEDA",
        "authorized_official_first_name": "MALCOLM",
        "authorized_official_middle_name": "LEAL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "308-675-1931",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "110175",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NE",
            "license": "39208",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026009700",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Grand Island, NE
• Providers in Grand Island, NE by specialty
• Family Nurse Practitioner in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2015; 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.