Epworth Village, Inc.

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

License

79772233 Issued in NE

Legal business name

EPWORTH VILLAGE, INC.

Practice address

2119 N Division Ave
York, NE 68467-1009

Phone

(402) 362-3353

NPI assigned

Jul 13, 2006

Last updated

Sep 21, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Thomas G. McBride

Title

President/Ceo

Phone

(402) 362-3353

Specialties & licenses 1

Addresses

Other identifiers 6

Tax ID family

Epworth Village2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Epworth Village

  • Psychiatric Residential Treatment Facility
  • York, NE
  • NPI 1528310133
  NPD tax ID

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.

• Laura Lee Miller, RN

  • Registered Nurse
  • York, NE
  • NPI 1326322637
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316563200000",
    "number": "1962427781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 503",
            "address_2": "2119 DIVISION AVE.",
            "city": "YORK",
            "state": "NE",
            "postal_code": "684670503",
            "telephone_number": "402-362-3353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2119 N DIVISION AVE",
            "city": "YORK",
            "state": "NE",
            "postal_code": "684671009",
            "telephone_number": "402-362-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPWORTH VILLAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2011-09-21",
        "status": "A",
        "authorized_official_last_name": "MCBRIDE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "402-362-3353",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "NE",
            "license": "79772233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100260591-00",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100260386-00",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100260389-00",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100260387-00",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100260401-00",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100260385-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donelle Ellison, RN
• April A Emeigh, LICSW
• Anastasia Emick-Suhr
• Jenice R. Epp, SLP
• Epworth Village
• Kaitlyn Ericson
• Sara Erlenbusch, RN
• Randy Lee Ervin, PSYD
• Joseph C. Erwin, M.D.
• Victoria Escalera

• Psychiatric Residential Treatment Facility in York, NE
• Providers in York, NE by specialty
• Psychiatric Residential Treatment Facility in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; 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.