JENNIE M MELHAM MEMORIAL MEDICAL CENTER INC (NPI# 1366659773) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366659773 |
| Entity Type | Organization |
| Organization Name | JENNIE M MELHAM MEMORIAL MEDICAL CENTER INC |
| Practice Address |
145 Memorial Dr Broken Bow NE 68822-1378 |
| Mailing Address |
Po Box 250 Broken Bow NE 68822-0250 |
| Practice Telephone | 3088724100 |
| Practice Fax Number | 3088724175 |
| Mailing Telephone | 3088724100 |
| Mailing Fax Number | 3088724175 |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2018-02-06 |
| Authorized Official Name | MS. VERONICA L SCHMIDT (PRESIDENT/CEO) |
| Authorized Official Telephone | 3088724100 |
| Is Organization Subpart | Y |
| Parent Organization Name | JENNIE M MELHAM MEMORIAL MEDICAL CENTER INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | 10025055300 | 05 | |
| NE | BLUE CROSS DIABETIC ED NO | 81010 | 01 |
| NE | BLUE CROSS CRNA NUMBER | 07073 | 01 |
| NE | RAILROAD MEDICARE NUMBER | DB7316 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982779641 | Jennie M Melham Memorial Medical Center Inc | Medicare Defined Swing Bed Unit | 145 Memorial Dr, Broken Bow, NE 68822-1378 | 2006-11-21 |
| 1538232244 | Jennie M Melham Memorial Medical Center Inc | General Acute Care Hospital | 145 Memorial Dr, Broken Bow, NE 68822-1378 | 2006-11-17 |
| 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 |
| 1609937598 | Loren Henning Jacobsen | Family Medicine | 145 Memorial Dr, Broken Bow, NE 68822-1378 | 2006-12-13 |
| 1093880072 | Jennie M Melham Memorial Medical Center | Nursing Facility/Intermediate Care Facility | 145 Memorial Dr, Broken Bow, NE 68822-1378 | 2006-11-22 |
| 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 | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497103568 | Ryan William Stagemeyer | Nurse Anesthetist, Certified Registered | 136 E Fairview St, Albion, NE 68620-1630 | 2016-05-31 |
| 1699123976 | Walross Jim Basit | Nurse Anesthetist, Certified Registered | 4544 Bancroft Ave Apt 4, Lincoln, NE 68506-4272 | 2016-05-27 |
| 1053768945 | Clark Jackson | Nurse Anesthetist, Certified Registered | 2500 S 60th St Apt 21, Lincoln, NE 68506-3579 | 2016-05-20 |
| 1750736211 | Ruben Chavez | Nurse Anesthetist, Certified Registered | 420 W 5th St Ste 101, Hastings, NE 68901-7551 | 2016-05-03 |
| 1427443159 | Jessica Thurlow | Nurse Anesthetist, Certified Registered | 11154 County Road 19, Blair, NE 68008-3626 | 2015-03-31 |
| 1972997062 | Kellyn Nieland | Nurse Anesthetist, Certified Registered | 5913 N 166th Ct, Omaha, NE 68116-3715 | 2015-03-26 |
| 1548678162 | Matthew Skaggs | Nurse Anesthetist, Certified Registered | 79711 467th Ave, Arcadia, NE 68815 | 2014-07-28 |
| 1376961706 | Jennifer Kjolhede | Nurse Anesthetist, Certified Registered | 15435 Douglas Cir, Omaha, NE 68154-2051 | 2014-04-02 |
| 1093051989 | Carl C Blackwood | Nurse Anesthetist, Certified Registered | 5701 Lillibridge St Apt 10, Lincoln, NE 68506-3543 | 2012-12-20 |
| 1801027479 | James Allen Grosshans | Nurse Anesthetist, Certified Registered | 645 Osage, Memorial Health Center, Sidney, NE 69162 | 2009-07-30 |
| Find all providers with the same taxonomy | ||||
| City | BROKEN BOW |
| Zip Code | 68822 |
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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.