PROVIDENCE MEDICAL CENTER (NPI# 1255470092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255470092 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE MEDICAL CENTER |
| Practice Address |
1200 Providence Rd Wayne NE 68787-1212 |
| Mailing Address |
1200 Providence Rd. Wayne NE 68787-1212 |
| Practice Telephone | 4023753800 |
| Practice Fax Number | 4023757989 |
| Mailing Telephone | 4023753800 |
| Mailing Fax Number | 4023757989 |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2012-03-01 |
| Authorized Official Name | THOMAS J. LEE (ADMINISTRATOR) |
| Authorized Official Telephone | 4023753800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 275N00000X | Medicare Defined Swing Bed Unit | 800001 | NE | Hospital Units |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457819922 | Providence Medical Center | Pharmacy | 803 Providence Rd Ste 101, Wayne, NE 68787-1590 | 2019-03-04 |
| 1801867494 | Providence Medical Center | General Acute Care Hospital | 1200 Providence Road, Wayne, NE 68787-1212 | 2006-01-31 |
| 1982957015 | Providence Medical Center | Clinic/Center | 417 First Ave, Seward, AK 99664-0365 | 2012-10-26 |
| 1639218472 | Providence Medical Center | Hospice Care, Community Based | 1200 Providence Rd, Wayne, NE 68787-1212 | 2007-02-06 |
| 1962567354 | Providence Medical Center | Family Medicine | 25 Craig Pl, North Plainfield, NJ 07060-4777 | 2006-12-26 |
| 1003971748 | Providence Medical Center | Home Health | 1200 Providence Rd, Wayne, NE 68787-1212 | 2006-12-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PROVIDENCE MEDICAL CENTER | 8929 Parallel Pkwy, Kansas City, KS 66112-1689 |
| System for Award Management (SAM) Entities | PROVIDENCE MEDICAL CENTER, WAYNE, NEBRASKA | 1200 Providence Rd, Wayne, NE 68787-1212 |
| Street Address |
1200 PROVIDENCE RD |
| City | WAYNE |
| State | NE |
| Zip Code | 68787-1212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700832839 | Todd Luedeke | Nurse Anesthetist, Certified Registered | 1200 Providence Rd, Wayne, NE 68787-1212 | 2006-05-26 |
| 1700404811 | Catherine Andela-ruth | Nurse Practitioner | 1200 Providence Rd, Wayne, NE 68787-1212 | 2020-07-06 |
| 1962032292 | Bonnie Lane Vrbicky | Physician Assistant | 1200 Providence Rd, Wayne, NE 68787-1212 | 2020-01-26 |
| 1497308662 | Midtown Health Center, Inc. | Clinic/Center | 1200 Providence Rd, Wayne, NE 68787-1212 | 2019-07-17 |
| 1326504267 | Kathy I Mohlfeld | Counselor | 1200 Providence Rd, Wayne, NE 68787-1299 | 2019-02-15 |
| 1114388303 | Timothy Ellis | Specialist/Technologist | 1200 Providence Rd, Wayne, NE 68787-1212 | 2016-03-15 |
| 1588022503 | John Miller | Physical Therapist | 1200 Providence Rd, Wayne, NE 68787-1212 | 2016-02-04 |
| 1598134751 | Morgan Ebberson | Occupational Therapist | 1200 Providence Rd, Wayne, NE 68787-1212 | 2015-09-17 |
| 1477922631 | Britni Nordhues | Occupational Therapist | 1200 Providence Rd, Wayne, NE 68787-1212 | 2015-09-17 |
| 1083977474 | Amy Joan Bowers | Physical Therapist | 1200 Providence Rd, Wayne, NE 68787 | 2012-06-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396209623 | Pearl Street Counseling, LLC | Counselor | 421 N Pearl Street, Wayne, NE 68787 | 2019-01-31 |
| 1760883367 | Northeast Nebraska Public Health Department | Public Health or Welfare | 215 Pearl Street, Wayne, NE 68787 | 2014-09-15 |
| 1942419353 | Muffin Elaine Morris | Specialist/Technologist | 11 11 Main Street, Wayne State College, Wayne, NE 68787 | 2007-05-22 |
| 1801952601 | Craig W Braun | Dentist | 206 E 7th St, Wayne, NE 68787 | 2006-12-28 |
| 1124120464 | Robert Kevin Krugman | Chiropractor | 214 Pearl Street, Wayne, NE 68787 | 2006-09-05 |
| 1659722908 | Michele Albers | Physical Therapist | 1200 Providence Road, Wayne, NE 68787 | 2016-06-28 |
| 1730599762 | Angela Mclaughlin | Family Medicine | 615 E 14th St, Wayne, NE 68787 | 2014-04-29 |
| 1649568775 | Grace Counseling Services | Community/Behavioral Health | 111 Main Street, Wayne, NE 68787 | 2011-07-11 |
| 1780975144 | Magnuson Hopkins Eyecare PC | Optometrist | 1112 W 7th St, Wayne, NE 68787 | 2011-04-20 |
| 1497925556 | Peterson Therapy Services LLC | Physical Therapist | 208 N. Main St., Wayne, NE 68787 | 2008-03-05 |
| Find all providers in zip 68787 | ||||
| Taxonomy Code | 275N00000X |
| Grouping | Hospital Units |
| Classification | Medicare Defined Swing Bed Unit |
| A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. |
| Notes: Source: Code of Federal Regulations #42, Section 482.66. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548391709 | Memorial Community Hospital Corporation | Medicare Defined Swing Bed Unit | 810 N. 22nd St, Blair, NE 68008-1128 | 2007-03-08 |
| 1982779039 | Gordon Memorial Hospital | Medicare Defined Swing Bed Unit | 300 East 8th, Gordon, NE 69343-1123 | 2006-11-22 |
| 1538264403 | Warren Memorial Hospital | Medicare Defined Swing Bed Unit | 905 2nd Street, Friend, NE 68359-1133 | 2006-09-14 |
| 1770541419 | Webster County Community Hospital | Medicare Defined Swing Bed Unit | 6th Street & Franklin Street, Red Cloud, NE 68970-0465 | 2006-05-03 |
| 1255334660 | Franklin County Memorial Hospital | Medicare Defined Swing Bed Unit | 1406 Q St, Franklin, NE 68939-1073 | 2005-05-31 |
| 1306377783 | Merrick Medical Center | Medicare Defined Swing Bed Unit | 1715 26th St, Central City, NE 68826-9501 | 2017-03-27 |
| 1073865168 | Facial Surgery Institute | Medicare Defined Swing Bed Unit | 2727 S 144th St, Suite 235, Omaha, NE 68144-5225 | 2012-10-12 |
| 1861765034 | Alegent Creighton Health | Medicare Defined Swing Bed Unit | 704 N 3rd St, Plainview, NE 68769-2047 | 2012-02-17 |
| 1134382849 | Chadron Community Hospital Corp. | Medicare Defined Swing Bed Unit | 825 Centennial Dr., Chadron, NE 69337-9400 | 2008-07-03 |
| 1003968710 | Ogallala Community Hospital | Medicare Defined Swing Bed Unit | 2601 N Spruce St, Ogallala, NE 69153-2465 | 2007-01-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.