DR. DENISE M. SAMMONS (NPI# 1316030448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316030448 |
| Entity Type | Individual |
| Full Name | DR. DENISE M. SAMMONS |
| Credential | M.D. |
| Practice Address |
4111 4th Ave Ste 2 Kearney NE 68845-2883 |
| Mailing Address |
21 Redwood Dr Kearney NE 68845-9582 |
| Practice Telephone | 3082371102 |
| Mailing Telephone | 3082240131 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-06-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 17984 | NE | Allopathic & Osteopathic Physicians |
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | MIDLANDS CHOICE | 4366 | 01 |
| NE | BCBS OF NE | 06354 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 21 Redwood Dr, Kearney, NE 688459582 | 3082240131 |
| Street Address |
4111 4TH AVE STE 2 |
| City | KEARNEY |
| State | NE |
| Zip Code | 68845-2883 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851908453 | Krystal Mae Wright | Peer Specialist | 4111 4th Ave Ste 2, Kearney, NE 68845-2883 | 2020-09-28 |
| 1023631124 | Terrill Jacobsen | Peer Specialist | 4111 4th Ave Ste 2, Kearney, NE 68845-2883 | 2020-05-22 |
| 1861015950 | April L Picard | Peer Specialist | 4111 4th Ave Ste 2, Kearney, NE 68845-2883 | 2020-05-22 |
| 1972126076 | Jennifer Schutz | Peer Specialist | 4111 4th Ave Ste 2, Kearney, NE 68845-2883 | 2020-05-22 |
| 1811510910 | Rebekah Wells | Peer Specialist | 4111 4th Ave Ste 2, Kearney, NE 68845-2883 | 2020-05-22 |
| 1922591486 | Brittni Waters | Peer Specialist | 4111 4th Ave Ste 2, Kearney, NE 68845-2883 | 2018-06-10 |
| 1841783305 | Melissa Walker | Peer Specialist | 4111 4th Ave Ste 2, Kearney, NE 68845-2883 | 2018-06-10 |
| 1659864114 | Starla Henderson | Peer Specialist | 4111 4th Ave Ste 2, Kearney, NE 68845-2883 | 2018-06-10 |
| 1316430853 | Angie Vieyra | Peer Specialist | 4111 4th Ave Ste 2, Kearney, NE 68845-2883 | 2018-06-09 |
| 1700378643 | Shannon Haussermann | Peer Specialist | 4111 4th Ave Ste 2, Kearney, NE 68845-2883 | 2018-06-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407465966 | Prairie Meadows Dental, PC | Clinic/Center | 1055 West 56th Street, Kearney, NE 68845 | 2020-07-30 |
| 1508408584 | Sandhills Oral & Facial Surgery LLC | Clinic/Center | 504 W 42nd Street, Kearney, NE 68845 | 2019-10-11 |
| 1699252395 | Lindustries, LLC | Clinic/Center | 4107 7th Avenue, Kearney, NE 68845 | 2018-07-25 |
| 1154846764 | Michele Ekberg | Speech-Language Pathologist | 76 Plaza Boulevard, Kearney, NE 68845 | 2017-08-04 |
| 1457721706 | Lesa Clifford | Speech-Language Pathologist | 4125 Summitt Rd, Kearney, NE 68845 | 2015-09-30 |
| 1154703353 | Andrew Michael Prososki | Family Medicine | 2403 West 47 Street Place, Kearney, NE 68845 | 2015-06-24 |
| 1710395561 | Justin Rethorst | Specialist/Technologist | 2810 West 35th St, Kearney, NE 68845 | 2014-07-24 |
| 1265877567 | Kearney Regional Medical Center LLC | General Acute Care Hospital | 804 22nd Avenue, Kearney, NE 68845 | 2013-05-01 |
| 1386906972 | Terry L. Dunlop | Counselor | 2315 W. 39th St., Suite 109, Kearney, NE 68845 | 2012-06-11 |
| 1437431913 | Sarah Winfield Thibault | Counselor | 3532 West Capital Ave, Grand Island, NE 68845 | 2011-09-12 |
| Find all providers in zip 68845 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851908453 | Krystal Mae Wright | Peer Specialist | 4111 4th Ave Ste 2, Kearney, NE 68845-2883 | 2020-09-28 |
| 1023631124 | Terrill Jacobsen | Peer Specialist | 4111 4th Ave Ste 2, Kearney, NE 68845-2883 | 2020-05-22 |
| 1861015950 | April L Picard | Peer Specialist | 4111 4th Ave Ste 2, Kearney, NE 68845-2883 | 2020-05-22 |
| 1972126076 | Jennifer Schutz | Peer Specialist | 4111 4th Ave Ste 2, Kearney, NE 68845-2883 | 2020-05-22 |
| 1811510910 | Rebekah Wells | Peer Specialist | 4111 4th Ave Ste 2, Kearney, NE 68845-2883 | 2020-05-22 |
| 1922591486 | Brittni Waters | Peer Specialist | 4111 4th Ave Ste 2, Kearney, NE 68845-2883 | 2018-06-10 |
| 1841783305 | Melissa Walker | Peer Specialist | 4111 4th Ave Ste 2, Kearney, NE 68845-2883 | 2018-06-10 |
| 1659864114 | Starla Henderson | Peer Specialist | 4111 4th Ave Ste 2, Kearney, NE 68845-2883 | 2018-06-10 |
| 1316430853 | Angie Vieyra | Peer Specialist | 4111 4th Ave Ste 2, Kearney, NE 68845-2883 | 2018-06-09 |
| 1700378643 | Shannon Haussermann | Peer Specialist | 4111 4th Ave Ste 2, Kearney, NE 68845-2883 | 2018-06-06 |
| Find all providers in KEARNEY | ||||
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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.