BELLEVUE PRIMARY HEALTHCARE PC (NPI# 1497091888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497091888 |
| Entity Type | Organization |
| Organization Name | BELLEVUE PRIMARY HEALTHCARE PC |
| Practice Address |
12717 S 28th Ave Bellevue NE 68123-3232 |
| Mailing Address |
703 Canyon Rd Bellevue NE 68005-2735 |
| Practice Telephone | 4025256976 |
| Mailing Telephone | 4025256976 |
| Enumeration Date | 2012-12-12 |
| Last Update Date | 2012-12-12 |
| Authorized Official Name | MRS. KELLI RAE PAVLISH (NURSE PRACTITIONER) |
| Authorized Official Telephone | 4025256976 |
| Authorized Official Credential | APRN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
111265 | NE | Ambulatory Health Care Facilities |
| Street Address |
12717 S 28TH AVE |
| City | BELLEVUE |
| State | NE |
| Zip Code | 68123-3232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679634588 | Douglas R. Penington | Nurse Practitioner | 12717 S 28th Ave, Bellevue, NE 68123-3232 | 2006-12-13 |
| 1497276893 | Hamilton Counseling | Clinic/Center | 12717 S 28th Ave, Bellevue, NE 68123-3232 | 2017-07-06 |
| 1023392651 | Roy W.holeyfield Jr. M.d. P.C. | Internal Medicine | 12717 S 28th Ave, Bellevue, NE 68123-3232 | 2011-09-30 |
| 1255611059 | Kelli R. Pavlish | Nurse Practitioner | 12717 S 28th Ave, Bellevue, NE 68123-3232 | 2011-08-24 |
| 1871804385 | Michael Jay Cooperman | Physical Therapist | 12717 S 28th Ave, Bellevue, NE 68123-3232 | 2010-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407482227 | Gloria Pettigrew-fletcher | Community Health Worker | 12432 A 36th St, C20, Bellevue, NE 68123 | 2020-03-13 |
| 1225480676 | Heidi Jean Mccoy | Dentist | 2110 Towne Centre Drive, Bellevue, NE 68123 | 2016-07-11 |
| 1538557442 | Mariam Abdelghany I | Physician Assistant | 2500 Bellevue Medical Center Drive, Bellevue, NE 68123 | 2014-12-30 |
| 1205243367 | Sara Johnson | Pharmacist | 3614 Twin Creeks Drive, Bellevue, NE 68123 | 2014-07-21 |
| 1174826747 | Francine Amy Drummond | Dentist | 1701 Independence Lane #22, Bellevue, NE 68123 | 2010-12-21 |
| 1053509588 | Dunlow Orthodontics, P.C. | Dentist | 2219 Capehart Road, Suite 102, Bellevue, NE 68123 | 2007-10-10 |
| 1801911870 | Michelle Lynn Gaeth | Dentist | 11536 S. 31st St., Bellevue, NE 68123 | 2007-03-20 |
| 1386789832 | Mary Monique Rotert | Psychologist | 3308 Samson Way Road, Suite 211, Bellevue, NE 68123 | 2007-02-21 |
| 1316084098 | Kevin B Jones | Family Medicine | 3308 Samson Way Ste 102, Bellevue, NE 68123 | 2007-01-31 |
| 1467529727 | Nebraska Medical Center | Pharmacy | 2510 Bellevue Medical Center Drive, Suite 100, Bellevue, NE 68123 | 2006-11-29 |
| Find all providers in zip 68123 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235539750 | Dfas-jfll/in | Clinic/Center | 4005 Raynor Pkwy Apt 3316, Bellevue, NE 68123-6110 | 2014-09-03 |
| 1437320645 | The Center for Optimal Health | Clinic/Center | 16236 Se 24th St, Bellevue, WA 98008-5408 | 2008-03-14 |
| 1013185909 | Mediart Family Clinic | Clinic/Center | 1530 140th Ave Ne Ste 101, Bellevue, WA 98005-4574 | 2008-02-14 |
| 1326458282 | Steven Yee Md LLC | Clinic/Center | 14505 Bel Red Rd, Suite 100, Bellevue, WA 98007-3936 | 2014-04-30 |
| 1720306780 | Factoria Women & Family Clinic | Clinic/Center | 4140 Factoria Blvd Se Ste A, Bellevue, WA 98006-5261 | 2010-05-13 |
| 1386818912 | New Horizons Natural Health LLC | Clinic/Center | 1530 140th Ave Ne, Suite 101, Bellevue, WA 98005-4574 | 2008-04-15 |
| 1598941551 | Doctors of Bellevue-redmond, Pllc | Clinic/Center | 15710 Ne 24th Street, Ste C, Bellevue, WA 98008-2444 | 2008-01-21 |
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|---|---|---|---|---|
| 1699396150 | Ageless Men's Health Series II Ne LLC | Clinic/Center | 5715 S 34th St Ste 400, Lincoln, NE 68516-6648 | 2020-05-06 |
| 1225669757 | Nextgen Male Medical Clinic LLC | Clinic/Center | 17602 Wright St Ste 105, Omaha, NE 68130-2097 | 2020-02-03 |
| 1497386601 | Kucera Chiropractic and Acupuncture, LLC | Clinic/Center | 1404 N 203rd St Ste 104, Elkhorn, NE 68022-2241 | 2020-01-28 |
| 1558912220 | Careatc | Clinic/Center | 2805 S 88th St Ste 101, Omaha, NE 68124-3065 | 2019-09-24 |
| 1063072551 | Revelation Health & Wellness LLC | Clinic/Center | 249 Olson Dr Ste 103, Papillion, NE 68046-2974 | 2019-06-17 |
| 1184143943 | Community Medical Center, Inc | Clinic/Center | 3307 Barada Street, Falls City, NE 68355 | 2017-09-13 |
| 1508316720 | Regeneration P.C. | Clinic/Center | 6030 Village Dr Ste 100, Lincoln, NE 68516-4773 | 2016-10-12 |
| 1861941999 | Brad Rodgers Md Family Practice & Sports Medicine | Clinic/Center | 3500 Central Ave Ste A, Kearney, NE 68847-2963 | 2016-09-30 |
| 1053760504 | Central Nebraska Medical Clinic Arcadia | Clinic/Center | 110 West Bridge Street, Arcadia, NE 68815 | 2016-06-06 |
| 1205264231 | Coddington Medical Family Practice | Clinic/Center | 1336 West A Street, Suite A, Lincoln, NE 68522 | 2013-10-30 |
| Find all providers with the same taxonomy | ||||
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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.