NPIMap

Organization Active NPI

ENT Physicians of Kearney, P.C.

  • Otolaryngology Physician
  • Kearney, NE
National Provider Identifier
1992795629
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
ENT PHYSICIANS OF KEARNEY, P.C.
Practice address
615 West 39TH Street
Kearney, NE 68845-8001
Phone
(308) 865-2277
Fax
(308) 865-2523
NPI assigned
Oct 25, 2005
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Reggie D Davis
Title
Office Manager
Phone
(308) 865-2277

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X NU Primary
Audiologist 231H00000X NU
Audiologist-Hearing Aid Fitter 237600000X NU

Addresses

Primary practice location

615 West 39TH Street
Kearney, NE 68845-8001

Mailing address

615 West 39TH Street
Kearney, NE 68845-8001
Phone (308) 865-2277

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040709000263 NE Part B Supplier - Clinic/Group Practice 3678551439 Receives reassigned benefits from 12 practitioners
Practice locations: Grand Island, NE; Kearney, NE

National Provider Directory

National Provider Directory

Locations

920 20th St
Gothenburg, NE 69138

615 W 39th St
Kearney, NE 68845
Phone (308) 698-2820

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16359/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1992795629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 WEST 39TH STREET",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688458001",
            "telephone_number": "308-865-2277",
            "fax_number": "308-865-2523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 WEST 39TH STREET",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688458001",
            "telephone_number": "308-865-2277",
            "fax_number": "308-865-2523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENT PHYSICIANS OF KEARNEY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-25",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "REGGIE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "308-865-2277"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Apr 20, 2008; 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.