DR. BRENT WAYNE KEENPORTZ (NPI# 1912026790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912026790 |
| Entity Type | Individual |
| Full Name | DR. BRENT WAYNE KEENPORTZ |
| Credential | M.D. |
| Practice Address |
2620 W Faidley Ave Grand Island NE 68803-4205 |
| Mailing Address |
16405 Weir St Omaha NE 68135-1218 |
| Practice Telephone | 3083985424 |
| Mailing Telephone | 4026991991 |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
19924 | NE | Allopathic & Osteopathic Physicians |
| Street Address |
2620 W FAIDLEY AVE |
| City | GRAND ISLAND |
| State | NE |
| Zip Code | 68803-4205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194701276 | Susan Elaine Beaty | Registered Nurse | 2620 W Faidley Ave, Wound Ostomy Healing Center, Grand Island, NE 68803-4205 | 2005-12-20 |
| 1780200139 | Emily Rae Christensen | Nurse Practitioner | 2620 W Faidley Ave, Grand Island, NE 68803-4205 | 2020-06-22 |
| 1720621121 | Rachel James | Nurse Practitioner | 2620 W Faidley Ave, Grand Island, NE 68803-4205 | 2019-10-18 |
| 1245724137 | Suellen Ranee Bruguera | Nurse Practitioner | 2620 W Faidley Ave, Grand Island, NE 68803-4205 | 2018-06-14 |
| 1508357930 | Midwest Emergency Grand Island Inc | Emergency Medicine | 2620 W Faidley Ave, Grand Island, NE 68803-4205 | 2018-05-22 |
| 1740782770 | Lpp of Nebraska LLC | Emergency Medicine | 2620 W Faidley Ave, Grand Island, NE 68803-4205 | 2018-03-06 |
| 1528588357 | Chelsea Mae Pedroza | Nurse Practitioner | 2620 W Faidley Ave, Grand Island, NE 68803-4205 | 2017-06-22 |
| 1477009686 | Zeeshan Khalid | Internal Medicine | 2620 W Faidley Ave, Grand Island, NE 68803 | 2016-08-28 |
| 1902251010 | Shoaib Junejo | Internal Medicine | 2620 W Faidley Ave, Grand Island, NE 68803-4205 | 2016-04-26 |
| 1730593823 | Suresh Manapuram | Internal Medicine | 2620 W Faidley Ave, Dept of Hospital Medicine, Grand Island, NE 68803 | 2014-06-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467053884 | Christopher Patrin | Counselor | 1811 West 2nd Street, Suite 450, Grand Island, NE 68803 | 2020-11-03 |
| 1942848593 | Specialized Outpatient Services | Counselor | 1811 West 2nd Street Suite 450, Grand Island, NE 68803 | 2019-12-13 |
| 1558910604 | Grand Island Regional Medical Center | General Acute Care Hospital | 3533 Prairieview Street, Grand Island, NE 68803 | 2019-09-10 |
| 1992225817 | Destiny Mostek | Dietitian, Registered | 2201 N. Broadwell Ave, Grand Island, NE 68803 | 2017-06-21 |
| 1184150591 | Brandy Rae Bird | Registered Nurse | Mosaic Msu 2905 West 5th Street, Grand Island, NE 68803 | 2017-05-04 |
| 1831633171 | Karla Jean Sextro | Counselor | 2112 W. Faidley Ave, Grand Island, NE 68803 | 2016-12-06 |
| 1689062895 | Good Hands Clinic PC | Specialist | 524 South Webb Rd, Suite 1, Grand Island, NE 68803 | 2014-12-23 |
| 1346664554 | Lindsey M Modlin | Dental Hygienist | 4234 New York Ave, Grandi Island, NE 68803 | 2014-02-07 |
| 1568711711 | Danessa Marie Kenney | Counselor | 908 N. Howard Ave. Suite 107, Nebraska Children's Home Society, Grand Island, NE 68803 | 2012-09-04 |
| 1649528563 | Nicole Morris | Physical Therapist | 2116 Faidley Ave, Grand Island, NE 68803 | 2012-08-27 |
| Find all providers in zip 68803 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215972047 | Suzette Anne Woodward | Pathology | 2620 W Faidley Ave, Grand Island, NE 68803-4205 | 2006-06-17 |
| 1073579207 | Kris L Mleczko | Pathology | 2620 W Faidley Ave, St. Francis Med. Ctr., Grand Island, NE 68803-4205 | 2006-04-25 |
| 1487627931 | Scott Alan Frankforter | Pathology | 2620 W Faidley Ave, Grand Island, NE 68803-4205 | 2006-02-07 |
| 1871565689 | Pathology Specialists, L.L.C. | Pathology | 2620 W Faidley Ave, Grand Island, NE 68803-4205 | 2006-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437793775 | Integrated Diagnostics LLC | Pathology | 201 E 4th St Ste 203, South Sioux City, NE 68776-1706 | 2019-10-30 |
| 1437704251 | Integrated Diagnostics | Pathology | 201 East 4th Street, Suite 203, South Sioux City, NE 68776 | 2019-08-08 |
| 1083275143 | Changzhao Li | Pathology | 7710 Mercy Road Suite 202-cu Department of Pathology, Omaha, NE 68124-2353 | 2019-06-27 |
| 1518482629 | Robert Elmore | Pathology | 7710 Mercy Road, Suite 202 - Cu Dept of Pathology, Omaha, NE 68106 | 2017-08-09 |
| 1720493380 | Sahara Cathcart | Pathology | Department of Pathology and Microbiology, 983135 Nebraska Medical Center, Omaha, NE 68198-3135 | 2014-06-23 |
| 1962757997 | Liyan Xu | Pathology | 601 N 30th Ste 1609, Omaha, NE 68131-2137 | 2012-07-16 |
| 1629365507 | Whitney R Wedel | Pathology | 3005 Harney St, Apt B2, Omaha, NE 68131-3538 | 2011-06-29 |
| 1710164074 | Manjiri S Lele | Pathology | 4545 R Street, Lincoln, NE 68503-3799 | 2008-01-29 |
| 1316144611 | Scott Alan Koepsell | Pathology | Unmc-pathology, 983135 Nmc, Omaha, NE 68198-3135 | 2007-06-29 |
| 1255538674 | Justin Dean Misko | Pathology | 983135 Nebraska Medical Ctr, Omaha, NE 68198-3135 | 2007-06-29 |
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| City | GRAND ISLAND |
| Zip Code | 68803 |
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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.