JENNIE M MELHAM MEMORIAL MEDICAL CENTER (NPI# 1245305655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245305655 |
| Entity Type | Organization |
| Organization Name | JENNIE M MELHAM MEMORIAL MEDICAL CENTER |
| Other Organization Name | CUSTER COUNTY HOSPICE |
| Practice Address |
145 Memorial Dr Broken Bow NE 68822-1378 |
| Mailing Address |
Po Box 250 Broken Bow NE 68822-0250 |
| Practice Telephone | 3088722625 |
| Practice Fax Number | 3088726116 |
| Mailing Telephone | 3088722625 |
| Mailing Fax Number | 3088726116 |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2020-01-10 |
| Authorized Official Name | MR. TIMOTHY L SCHUCKMAN (VICE PRESIDENT-CFO) |
| Authorized Official Telephone | 3088722625 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251G00000X | Hospice Care, Community Based | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS HOSPICE NUMBER | 00368 | 01 | |
| NE | 10025136500 | 05 |
| Other Name | Type Code |
|---|---|
| Custer County Hospice | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093880072 | Jennie M Melham Memorial Medical Center | Nursing Facility/Intermediate Care Facility | 145 Memorial Dr, Broken Bow, NE 68822-1378 | 2006-11-22 |
| 1336214394 | Jennie M Melham Memorial Medical Center | Home Health | 145 Memorial Dr, Broken Bow, NE 68822-1378 | 2006-11-22 |
| 1265507677 | Jennie M Melham Memorial Medical Center | Durable Medical Equipment & Medical Supplies | 145 Memorial Dr, Broken Bow, NE 68822-1378 | 2006-11-21 |
| Street Address |
145 MEMORIAL DR |
| City | BROKEN BOW |
| State | NE |
| Zip Code | 68822-1378 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528098407 | Julie A Lindstrom | Family Medicine | 145 Memorial Dr, Broken Bow, NE 68822-1378 | 2006-07-04 |
| 1386271419 | Valerie Harris | Counselor | 145 Memorial Dr, Broken Bow, NE 68822-1378 | 2020-03-26 |
| 1861959017 | Justin Boutwell | Physician Assistant | 145 Memorial Dr, Broken Bow, NE 68822-1378 | 2019-02-25 |
| 1982143764 | Jason S Brooks | Physician Assistant | 145 Memorial Dr, Broken Bow, NE 68822-1378 | 2017-02-14 |
| 1033657820 | Laci Kai Scott | Nurse Practitioner | 145 Memorial Dr, Broken Bow, NE 68822-1378 | 2017-02-01 |
| 1295199792 | Katie Thompson | Family Medicine | 145 Memorial Dr, Broken Bow, NE 68822-1378 | 2016-04-11 |
| 1811311921 | Jacob D Karmazin | Physician Assistant | 145 Memorial Dr, Broken Bow, NE 68822-1378 | 2014-02-10 |
| 1942400585 | Melissa Ann Kulhanek | Pharmacist | 145 Memorial Dr, Broken Bow, NE 68822-1378 | 2007-07-23 |
| 1366659773 | Jennie M Melham Memorial Medical Center Inc | Nurse Anesthetist, Certified Registered | 145 Memorial Dr, Broken Bow, NE 68822-1378 | 2007-05-16 |
| 1609937598 | Loren Henning Jacobsen | Family Medicine | 145 Memorial Dr, Broken Bow, NE 68822-1378 | 2006-12-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659898229 | Lauren Eliz Zimbelman | Occupational Therapy Assistant | Brookestone View, 850 Laurel Parkway Drive, Broken Bow, NE 68822 | 2017-08-24 |
| 1063868032 | Tanner Johnson | Specialist/Technologist | 79568 Sumner Rd., Broken Bow, NE 68822 | 2016-05-10 |
| 1730571837 | Quality Senior Villages | Clinic/Center | 715 Arapahoe Lane, Broken Bow, NE 68822 | 2015-02-26 |
| 1346660743 | Sheila Erickson | Case Manager/Care Coordinator | 323 S 7th Street, Broken Bow, NE 68822 | 2014-04-24 |
| 1497926570 | Sarah Tove Hansen | Community Health Worker | 850 Laurel Parkway Dr, Broken Bow, NE 68822 | 2008-03-18 |
| 1144320144 | John C Evans | Nurse Anesthetist, Certified Registered | 145 Memorial Dr., Broken Bow, NE 68822 | 2006-09-22 |
| 1588764583 | Timothy Bart Johnson | Nurse Anesthetist, Certified Registered | 79568 Sumner Road, Broken Bow, NE 68822 | 2006-09-22 |
| 1578668232 | Central Nebraska Medical Clinic PC | Family Medicine | 145 Memorial Drive, Broken Bow, NE 68822 | 2006-09-14 |
| 1265668172 | Errin M. Nelson | Physical Therapist | 325 South 1st Ave, Errin Nelson, Broken Bow, NE 68822-0435 | 2009-06-05 |
| 1083025571 | Deniece P Petersen | Physical Therapist | 325 S 1st Ave, Broken Bow, NE 68822-0435 | 2014-05-19 |
| Find all providers in zip 68822 | ||||
| Taxonomy Code | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174569594 | Heartland Hospice Services, Inc. | Hospice Care, Community Based | 605 S Park Dr, Suite 12, Broken Bow, OK 74728-5331 | 2006-06-22 |
| 1831215219 | Heartland Hospice-broken Bow | Hospice Care, Community Based | 605 S Park Dr, Suite 12, Broken Bow, OK 74728-5331 | 2007-03-21 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | BROKEN BOW |
| Zip Code | 68822 |
Please comment or provide details below to improve the information on JENNIE M MELHAM MEMORIAL MEDICAL CENTER.
| 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.