NPIMap

Organization Active NPI

Midtown Health Center, Inc.

Doing business as Midtown Health Center--Vets Home

  • Dental Clinic/Center
  • Norfolk, NE
National Provider Identifier
1992358824
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
MIDTOWN HEALTH CENTER, INC.
Doing business as
Midtown Health Center--Vets Home
Practice address
600 E Benjamin Ave
Norfolk, NE 68701-0830
Phone
(402) 371-8000
NPI assigned
Jul 19, 2019
Last updated
Jul 9, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
MIDTOWN HEALTH CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

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

Authorized official

Name
Melodee J Drenkow
Title
Systems Auditor/Credentialing
Phone
(402) 370-1064

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary
Federally Qualified Health Center (FQHC) 261QF0400X

Addresses

Primary practice location

600 E Benjamin Ave
Norfolk, NE 68701-0830

Mailing address

302 W Phillip Ave
Norfolk, NE 68701-5248
Phone (402) 371-8000

Other names 1

  • Midtown Health Center--Vets Home Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240729003225 NE Part A Provider - Federally Qualified Health Center (FQHC) 9133110182 Practice locations: Norfolk, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992358824. Details of each certification follow.

Federally qualified health center certification: CCN D01013

Legal name
MIDTOWN HEALTH CENTER INC
Doing business as
MIDTOWN HEALTH CENTER-VETS HOME
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 25, 2024
Last certification
Jul 25, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 13, 2014 in NE
Enrollment address
600 E Benjamin Ave
Norfolk, NE 68701-0830

Other NPIs with the same Medicare PAC ID 16

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

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Midtown Health Center Inc19 organizations share this tax ID, including this one
Part of
Midtown Health Center Inc

Other organizations with this tax ID 18

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

View all 18

Locations

110 N 16th St
Ste 16
Norfolk, NE 68701
Phone (402) 371-3300

110 N 16th St
Ste 32
Norfolk, NE 68701
Phone (402) 644-7314

1106 W Phillip Ave
Norfolk, NE 68701
Phone (402) 644-2544

1900 Vicki Ln
Norfolk, NE 68701
Phone (402) 370-3140

310 S 3rd St
Norfolk, NE 68701
Phone (402) 644-2550

406 N Cottonwood St
Norfolk, NE 68701
Phone (402) 644-2546

611 Meadow Ln
Norfolk, NE 68701
Phone (402) 644-2500

303 Plaza Dr
Lot 7
West Point, NE 68788

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Betty Froehlich Individual Corporate OfficerPast Board Chair Jan 1, 2004
Gretchen Forsell Individual Corporate OfficerBoard Member Jan 1, 2004
Mary Luhr Individual Corporate OfficerBoard Member Jan 1, 2016
Karie Langhorst Individual Corporate DirectorChief Financial Officer May 1, 2012
Brenda Jones Individual Corporate OfficerBoard Secretary Jan 1, 2008
Lance Morrow Individual Corporate OfficerBoard Treasurer Jan 1, 2016
Susie Lutz Individual Corporate OfficerBoard Chairman Jan 1, 2015
Karen Weidner Individual Corporate OfficerBoard Member Jan 1, 2001
Kathy Nordby Individual W-2 Managing EmployeeChief Executive Officer Jan 1, 2012
Melodee Drenkow Individual Operational/Managerial ControlQuality Management Director Sep 1, 2020

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Midtown Health Center IncNorfolk, NE, CCN 281812 Federally qualified health center Operational/Managerial Control Aug 1, 2008
Midtown Health Center - MadisonMadison, NE, CCN 281813 Federally qualified health center Operational/Managerial Control Apr 6, 2009

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594252800000",
    "number": "1992358824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 W PHILLIP AVE",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687015248",
            "telephone_number": "402-371-8000",
            "fax_number": "402-371-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E BENJAMIN AVE",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687010830",
            "telephone_number": "402-371-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDTOWN HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIDTOWN HEALTH CENTER, INC.",
        "enumeration_date": "2019-07-19",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A",
        "authorized_official_last_name": "DRENKOW",
        "authorized_official_first_name": "MELODEE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SYSTEMS AUDITOR/CREDENTIALING",
        "authorized_official_telephone_number": "402-370-1064"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midtown Health Center--Vets Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norfolk, NE

Sources for this page

Verify at the official NPI Registry.