NPIMap

Organization Active NPI

Bluestem Health

  • Federally Qualified Health Center (FQHC)
  • Lincoln, NE
National Provider Identifier
1932156114
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BLUESTEM HEALTH
Practice address
1021 N 27TH St
Lincoln, NE 68503-1803
Phone
(402) 476-1455
Fax
(402) 476-1670
NPI assigned
May 31, 2006
Last updated
Jan 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Authorized official

Name
Brad Lee Meyer
Title
Ceo
Phone
(402) 470-5424

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Mental Health Counselor 101YM0800X NU
Public Health Dentistry 1223D0001X NU
General Practice Dentistry 1223G0001X HC039 NE
Family Medicine Physician 207Q00000X NU
Pediatrics Physician 208000000X NU

Addresses

Primary practice location

1021 N 27TH St
Lincoln, NE 68503-1803

Mailing address

1021 N 27TH St
Lincoln, NE 68503-1803
Phone (402) 476-1455

Other identifiers 3

IdentifierTypeStateIssuer
10025024400MedicaidNE
100250244-00MedicaidNE
100250243-00MedicaidNE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address 3055.0001@direct.bluestemlincoln.nextgenshare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20030505000008 NE Part A Provider - Federally Qualified Health Center (FQHC) 6800706672 Practice locations: Lincoln, NE
O20040219000213 NE Part B Supplier - Clinic/Group Practice 6800706672 Receives reassigned benefits from 31 practitioners
7 other NPIs on this enrollment
Practice locations: Lincoln, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932156114. Details of each certification follow.

Federally qualified health center certification: CCN 281809

Legal name
BLUESTEM HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 19, 2003
Last certification
Nov 19, 2003
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Aug 21, 2002 in NE
Enrollment address
1021 N 27TH St
Lincoln, NE 68503-1803

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
28D1017099Bluestem Health Main Clinic1021 N 27TH Street, Lincoln, NE 68503Certificate of waiverSep 15, 2027

National Provider Directory

National Provider Directory

Locations

2301 O St
Ste 2
Lincoln, NE 68510
Phone (402) 441-6642

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jacque Fanning Individual Corporate OfficerCfo Sep 6, 2016
W-2 Managing EmployeeCfo Sep 6, 2016
Brad Meyer Individual Corporate OfficerCeo Sep 15, 2014
W-2 Managing EmployeeCeo Sep 15, 2014
Operational/Managerial ControlCeo Sep 15, 2014

Practitioners & affiliated clinicians

Practitioners 37

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.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1932156114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 N 27TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685031803",
            "telephone_number": "402-476-1455",
            "fax_number": "402-476-1670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 N 27TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685031803",
            "telephone_number": "402-476-1455",
            "fax_number": "402-476-1670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUESTEM HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "402-470-5424"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "HC039",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025024400",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100250244-00",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100250243-00",
            "state": "NE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "3055.0001@direct.bluestemlincoln.nextgenshare.com",
            "affiliation": "N",
            "address_1": "1021 N 27th St",
            "city": "Lincoln",
            "state": "NE",
            "country_code": "US",
            "postal_code": "685031803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.