NPIMap

Organization Active NPI

State of Nebraska Dept. of Admin. Services

  • Intellectual Disabilities Intermediate Care Facility
  • Beatrice, NE
National Provider Identifier
1962791764
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
ICFMR07 Issued in NE
Legal business name
STATE OF NEBRASKA DEPT. OF ADMIN. SERVICES
Practice address
3000 Lincoln St
3104 State Ave
Beatrice, NE 68310-3319
Phone
(402) 223-6600
Fax
(402) 223-7589
NPI assigned
Apr 1, 2011
Organization subpart
Yes
Parent organization
STATE OF NEBRASKA DEPT. OF ADMIN. SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Authorized official

Name
Corina Harrison
Title
Facility Administrator
Phone
(402) 223-6600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X ICFMR07 NE Primary

Addresses

Primary practice location

3000 Lincoln St
3104 State Ave
Beatrice, NE 68310-3319

Mailing address

3000 Lincoln St
3104 State Ave
Beatrice, NE 68310-3319
Phone (402) 223-6600

Other names 1

  • 400 State Building Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Western Nebraska Vetera27 organizations share this tax ID, including this one
Part of
Western Nebraska Vetera

Other organizations with this tax ID 26

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

View all 26

Locations

3000 Lincoln St
#3104
Beatrice, NE 68310
Phone (402) 223-6600

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1962791764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 LINCOLN ST",
            "address_2": "3104 STATE AVE",
            "city": "BEATRICE",
            "state": "NE",
            "postal_code": "683103319",
            "telephone_number": "402-223-6600",
            "fax_number": "402-223-7589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 LINCOLN ST",
            "address_2": "3104 STATE AVE",
            "city": "BEATRICE",
            "state": "NE",
            "postal_code": "683103319",
            "telephone_number": "402-223-6600",
            "fax_number": "402-223-7589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF NEBRASKA DEPT. OF ADMIN. SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF NEBRASKA DEPT. OF ADMIN. SERVICES",
        "enumeration_date": "2011-04-01",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "CORINA",
        "authorized_official_title_or_position": "FACILITY ADMINISTRATOR",
        "authorized_official_telephone_number": "402-223-6600"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NE",
            "license": "ICFMR07",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "400 State Building",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "400 State Building",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beatrice, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; 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.