PROVIDENCE MEDICAL CENTER (NPI# 1639218472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639218472 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE MEDICAL CENTER |
| Other Organization Name | PROVIDENCE HOSPICE |
| Practice 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 | 2012-07-26 |
| 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 | 251G00000X | Hospice Care, Community Based | HOSPICE 29 | NE | Agencies |
| Other Name | Type Code |
|---|---|
| Providence Hospice | Other Name - Individual/Organization |
| 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 |
| 1255470092 | Providence Medical Center | Medicare Defined Swing Bed Unit | 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 | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518167337 | Pennsylvania Trinity Hospice, LLC | Hospice Care, Community Based | 1255 Drummers Ln, Suite 100, Wayne, PA 19087-1565 | 2007-07-19 |
| 1245677020 | Brookdale Hospice of Philadelphia LLC | Hospice Care, Community Based | 995 Old Eagle School Rd, Suite 315, Wayne, PA 19087-1709 | 2013-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245719228 | Methodist Fremont Health | Hospice Care, Community Based | 2400 N Lincoln Ave Ste B, Fremont, NE 68025-2443 | 2018-08-09 |
| 1508303967 | Avalon Hospice Nebraska, LLC | Hospice Care, Community Based | 7441 O St Ste 104, Lincoln, NE 68510-2468 | 2017-01-24 |
| 1225433931 | Serenecare Inc | Hospice Care, Community Based | 4905 S 107th Ave Ste 205, Omaha, NE 68127-1965 | 2014-10-24 |
| 1811244213 | Fremont Health | Hospice Care, Community Based | 450 E 23rd Street, Fremont, NE 68025-2303 | 2012-08-06 |
| 1033481197 | Great Plains Hospice/north Platte Care Center | Hospice Care, Community Based | 600 E Francis St Ste 8&9, North Platte, NE 69101-6796 | 2012-02-06 |
| 1528341880 | The Mary Lanning Memorial Hospital Association | Hospice Care, Community Based | 926 East E Street, Good Samaritan Society - Hastings Village, Hastings, NE 68901-2149 | 2011-09-23 |
| 1982987244 | The Mary Lanning Memorial Hospital A | Hospice Care, Community Based | 400 East 7th Street, Harvard Rest Haven, Harvard, NE 68944-0546 | 2011-09-23 |
| 1346523602 | The Mary Lanning Memorial Hospital A | Hospice Care, Community Based | 636 North Locust Street, Heritage of Red Cloud, Red Cloud, NE 68970-2463 | 2011-09-23 |
| 1710269741 | The Mary Lanning Memorial Hospital A | Hospice Care, Community Based | 100 West Elm, Haven Home of Kenesaw, Kenesaw, NE 68956-0010 | 2011-09-15 |
| 1790067742 | The Mary Lanning Memorial Hospital A | Hospice Care, Community Based | 106 5th Street, Rosebrook Care Center, Edgar, NE 68935-3156 | 2011-09-15 |
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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.