NPIMap

Organization Active NPI

Central Nebraska Spinal Surgery Center, P.C.

  • Orthopaedic Surgery of the Spine Physician
  • Kearney, NE
National Provider Identifier
1962560698
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
Legal business name
CENTRAL NEBRASKA SPINAL SURGERY CENTER, P.C.
Practice address
816 22ND Ave Ste 101
Kearney, NE 68845-2226
Phone
(308) 865-2557
Fax
(308) 865-1461
NPI assigned
Dec 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Dr. David A Benavides, M.D.NPI 1033190996
Title
President
Phone
(308) 865-2557

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XS0117X Primary

Addresses

Primary practice location

816 22ND Ave Ste 101
Kearney, NE 68845-2226

Mailing address

816 22ND Ave Ste 101
Kearney, NE 68845-2226
Phone (308) 865-2557

Other practice location 1

3500 Central Ave
Suite A
Kearney, NE 68847-2944
Phone (308) 865-2557

Other identifiers 1

IdentifierTypeStateIssuer
10025346500MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060505000413 NE Part B Supplier - Clinic/Group Practice 0648281683 Receives reassigned benefits from 1 practitioner
Practice locations: Omaha, NE; MC Cook, NE; Kearney, NE; Gothenburg, NE

National Provider Directory

National Provider Directory

Locations

816 22nd Ave
Ste 101
Kearney, NE 68845
Phone (308) 865-2557

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1962560698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 22ND AVE STE 101",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452226",
            "telephone_number": "308-865-2557",
            "fax_number": "308-865-1461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 22ND AVE STE 101",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452226",
            "telephone_number": "308-865-2557",
            "fax_number": "308-865-1461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3500 Central Ave",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Kearney",
            "state": "NE",
            "postal_code": "688472944",
            "country_code": "US",
            "telephone_number": "308-865-2557",
            "fax_number": "308-865-1461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTRAL NEBRASKA SPINAL SURGERY CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "BENAVIDES",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "308-865-2557",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025346500",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.