Individual provider Active NPI

Madison J Nutter, PA

  • Physician Assistant
  • York, NE
National Provider Identifier
1922633957
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2473 Issued in NE
Practice address
2114 N Lincoln Ave Ste a
York, NE 68467-1072
Phone
(402) 362-5044
Fax
(402) 362-7137
NPI assigned
Mar 10, 2020
Last updated
Apr 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2473 NE Primary

Addresses

Primary practice location

2114 N Lincoln Ave Ste a
York, NE 68467-1072

Mailing address

2114 N Lincoln Ave Ste a
York, NE 68467-1072
Phone (402) 362-5044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200407001183 NE Practitioner - Physician Assistant 5496184814 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2473NEMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: madisonnutter@ynemcpc.allscriptsdirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1583798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1922633957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 N LINCOLN AVE STE A",
            "city": "YORK",
            "state": "NE",
            "postal_code": "684671072",
            "telephone_number": "402-362-5044",
            "fax_number": "402-362-7137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 N LINCOLN AVE STE A",
            "city": "YORK",
            "state": "NE",
            "postal_code": "684671072",
            "telephone_number": "402-362-5044",
            "fax_number": "402-362-7137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTTER",
        "first_name": "MADISON",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-10",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, NE

Sources for this page

Verify at the official NPI Registry.