CITY OF GENOA (NPI# 1104859206) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104859206 |
| Entity Type | Organization |
| Organization Name | CITY OF GENOA |
| Practice Address |
505 S Park St Genoa NE 68640-3036 |
| Mailing Address |
505 S Park St Po Box 310 Genoa NE 68640-3036 |
| Practice Telephone | 4029932206 |
| Practice Fax Number | 4029932595 |
| Mailing Telephone | 4029932206 |
| Mailing Fax Number | 4029932595 |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2020-01-23 |
| Authorized Official Name | AMANDA ROEBUCK (CEO) |
| Authorized Official Telephone | 4029934583 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | BLUE CROSS BLUE SHIELD | 273722254 | 01 |
| NE | CHAMPUS | NA | 01 |
| NE | 10025924300 NRH | 05 | |
| NE | RAILROAD MEDICARE | CS4410 | 01 |
| NE | NA RH | 05 | |
| NE | COMMERCIAL | 273722254 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710275060 | City of Genoa | Nursing Facility/Intermediate Care Facility | 706 Ewing Avenue, Genoa, NE 68640-3035 | 2011-07-20 |
| 1649228511 | City of Genoa | General Acute Care Hospital | 706 Ewing St, Genoa, NE 68640-3035 | 2006-05-04 |
| 1487621561 | City of Genoa | Ambulance | 516 Willard Ave, Genoa, NE 68640-3039 | 2006-03-07 |
| 1386157071 | City of Genoa | Clinic/Center | 303 Broadway St, Fullerton, NE 68638-3152 | 2017-11-16 |
| 1720505522 | City of Genoa | Clinic/Center | 505 S Park St, Genoa, NE 68640-3036 | 2017-08-23 |
| 1417395955 | City of Genoa | General Acute Care Hospital | 706 Ewing St, Genoa, NE 68640-3035 | 2013-06-06 |
| 1982979894 | City of Genoa | Hospice, Inpatient | 706 Ewing St, Genoa, NE 68640-3035 | 2012-03-12 |
| 1356638175 | City of Genoa | Assisted Living Facility | 706 Ewing St, Genoa, NE 68640-3035 | 2011-06-30 |
| Street Address |
505 S PARK ST |
| City | GENOA |
| State | NE |
| Zip Code | 68640-3036 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336127950 | Steve D Watton | Physician Assistant | 505 S Park St, Park Street Medical Clinic, Genoa, NE 68640-3036 | 2006-01-04 |
| 1578172045 | Lauren Esch | Family Medicine | 505 S Park St, Genoa, NE 68640-3036 | 2020-07-30 |
| 1720505522 | City of Genoa | Clinic/Center | 505 S Park St, Genoa, NE 68640-3036 | 2017-08-23 |
| 1386077535 | Jennifer Lynn Swantek | Nurse Practitioner | 505 S Park St, Genoa, NE 68640-3036 | 2013-08-12 |
| 1053671883 | Vicki D Peterson Truksa | Nurse Practitioner | 505 S Park St, Genoa, NE 68640-3036 | 2012-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790086999 | Park Street Medical Clinic PC | Family Medicine | 505 South Park Street, Genoa, NE 68640 | 2010-11-04 |
| 1679071724 | Elisa Jean Zeiss | Physician Assistant | Po Box 310, Genoa, NE 68640-0310 | 2018-01-23 |
| 1710275060 | City of Genoa | Nursing Facility/Intermediate Care Facility | 706 Ewing Avenue, Genoa, NE 68640-3035 | 2011-07-20 |
| 1649228511 | City of Genoa | General Acute Care Hospital | 706 Ewing St, Genoa, NE 68640-3035 | 2006-05-04 |
| 1730795659 | Paige Julianne Pauley | Physician Assistant | 706 Ewing St, Genoa, NE 68640-3035 | 2020-09-16 |
| 1710548292 | Jordan Sue Chohon | Physical Therapist | 706 Ewing St, Genoa, NE 68640-3035 | 2019-06-25 |
| 1720579220 | Kimberly Ann Pfeifer | Dietitian, Registered | 706 Ewing St, Genoa, NE 68640-3035 | 2018-05-21 |
| 1386150522 | Katelyn Elizabeth Palkovic | Physical Therapist | 706 Ewing St, Genoa, NE 68640-3035 | 2017-12-26 |
| 1326457730 | Kala Preister | Physical Therapist | 706 Ewing St, Genoa, NE 68640-3035 | 2014-08-11 |
| 1417395955 | City of Genoa | General Acute Care Hospital | 706 Ewing St, Genoa, NE 68640-3035 | 2013-06-06 |
| Find all providers in zip 68640 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 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 |
| 1235539750 | Dfas-jfll/in | Clinic/Center | 4005 Raynor Pkwy Apt 3316, Bellevue, NE 68123-6110 | 2014-09-03 |
| 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.