EHRLING BERGQUIST CLINIC (NPI# 1316919160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316919160 |
| Entity Type | Organization |
| Organization Name | EHRLING BERGQUIST CLINIC |
| Other Organization Name | 55TH MEDICAL GROUP |
| Practice Address |
2501 Capehart Rd Ste 105 Offutt A F B NE 68113-1043 |
| Practice Telephone | 4022949215 |
| Practice Fax Number | 4022947463 |
| Mailing Telephone | 4022949215 |
| Mailing Fax Number | 4022947463 |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2010-11-15 |
| Authorized Official Name | SERENA LYNN HANSKEN (AIR FORCE UNIFORM BUSINESS OFFICE) |
| Authorized Official Telephone | 7035886419 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers | ||
| N | 261QM1100X |
Clinic/Center Specialization: Military/U.S. Coast Guard Outpatient |
Ambulatory Health Care Facilities | ||
| N | 261QM1101X |
Clinic/Center Specialization: Military and U.S. Coast Guard Ambulatory Procedure |
Ambulatory Health Care Facilities | ||
| Y | 286500000X | Military Hospital | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | NCPDP | 2815706 | 01 |
| Other Name | Type Code |
|---|---|
| 55th Medical Group | Other Name - Individual/Organization |
| Street Address |
2501 CAPEHART RD STE 105 |
| City | OFFUTT A F B |
| State | NE |
| Zip Code | 68113-1043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841562212 | Kendra Lynn Haynes | Dental Hygienist | 2501 Capehart Rd, Offutt A F B, NE 68113-1043 | 2012-02-01 |
| 1275816902 | Jeremy Lee Hurst | Nurse Practitioner | 2501 Capehart Rd, Offutt A F B, NE 68113-1043 | 2011-09-20 |
| 1568758746 | Daniel Joseph Binkowski | Dentist | 2501 Capehart Rd, Offutt A F B, NE 68113-1043 | 2011-06-25 |
| 1427355866 | Andrea Jefferson | Military Health Care Provider | 2501 Capehart Rd, Offutt A F B, NE 68113-1043 | 2011-02-22 |
| 1447553169 | Jeffrey Grant Larkin | Dentist | 2501 Capehart Rd, Offutt A F B, NE 68113-1043 | 2010-12-20 |
| 1629309109 | Miriam E Flack | Dietitian, Registered | 2501 Capehart Rd, Offutt A F B, NE 68113-1043 | 2010-01-22 |
| 1194954412 | Molly Claire Goessling | Pharmacist | 2501 Capehart Rd, Offutt A F B, NE 68113-1043 | 2009-07-08 |
| 1447486253 | Aaron Michael Wulff | Dentist | 2501 Capehart Rd, Offutt A F B, NE 68113-1043 | 2009-06-08 |
| 1407082522 | Claude Alan Russo | Military Health Care Provider | 2501 Capehart Rd, Sgopf, Offutt A F B, NE 68113-1043 | 2009-06-03 |
| 1245465137 | Gregory Royce Beavers | Military Health Care Provider | 2501 Capehart Rd, Offutt A F B, NE 68113-1043 | 2009-05-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386133668 | Peter Mitchell Martin | Family Medicine | Offutt Afb Family Medicine Residency, 2501 Capehart Rd., Offutt Afb, NE 68113 | 2018-05-02 |
| 1619212792 | Tyrone Antonio Simon | Social Worker | 2501 Capehart Rd Bldg 4000, Offutt Afb, NE 68113 | 2012-11-30 |
| 1245536994 | Aaron Bradley Smith | Military Health Care Provider | Ehrling Bergquist Clinic, 2501 Capehart Rd, Offutt Afb, NE 68113 | 2011-01-28 |
| 1962719294 | Amy Elaine Klein | Optometrist | 106 Meyer Ave, Bldg 166, Offutt Afb, NE 68113 | 2010-09-08 |
| 1720248974 | Americas Best Contacts & Eyeglasses | Technician/Technologist | Bldg 166 Offutt Afb Exchange, Offutt Afb, NE 68113 | 2008-06-11 |
| 1548343296 | Jack David Wright | Pharmacist | 2501 Capehart, Erhling Bergquist Hospital, Offutt Afb, NE 68113 | 2006-10-23 |
| 1215023890 | Mark James Angerbauer | Dentist | 2501 Capehart Rd., Omaha, NE 68113 | 2006-10-04 |
| 1003915430 | 55th Medical Group Sgsl | Pharmacy | Bldg 107 Rm 101, Offutt, NE 68113 | 2006-09-22 |
| 1407804800 | Valerie June Malloy | Family Medicine | Offutt Afb, Erhling Berquist Clinic, Belluvue, NE 68113 | 2006-05-05 |
| 1457766909 | Robyn Thiede | Nurse Practitioner | 2501 Capehart Road, Family Medicine Residency Clinic, Ehrling Bergquist, Offutt Afb, NE 68113 | 2014-06-24 |
| Find all providers in zip 68113 | ||||
| Taxonomy Code | 286500000X |
| Grouping | Hospitals |
| Classification | Military Hospital |
| A health care facility operated by the Department of Defense. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508155516 | Va Hospital | Military Hospital | 4101 Woolworth Ave, Omaha, NE 68105-1850 | 2011-03-30 |
| City | OFFUTT A F B |
| Zip Code | 68113 |
Please comment or provide details below to improve the information on EHRLING BERGQUIST CLINIC.
| 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.