CHADRON MEDICAL CLINIC PC (NPI# 1417167370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417167370 |
| Entity Type | Organization |
| Organization Name | CHADRON MEDICAL CLINIC PC |
| Practice Address |
825 Centennial Dr Chadron NE 69337-9400 |
| Mailing Address |
825 Centennial Dr Po Box 431 Chadron NE 69337-9400 |
| Practice Telephone | 3084324441 |
| Practice Fax Number | 3084324446 |
| Mailing Telephone | 3084324441 |
| Mailing Fax Number | 3084324446 |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2010-06-15 |
| Authorized Official Name | TERESA J LANDRETH (OFFICE MANAGER) |
| Authorized Official Telephone | 3084324441 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | ========= | NE | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | BLUE SHIELD | 01981 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619455946 | Chadron Medical Clinic PC | Family Medicine | 825 Centennial Dr, Chadron, NE 69337 | 2018-07-30 |
| Street Address |
825 CENTENNIAL DR |
| City | CHADRON |
| State | NE |
| Zip Code | 69337-9400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912980327 | Jerry L Mclain | Family Medicine | 825 Centennial Dr, Chadron, NE 69337-9400 | 2005-11-21 |
| 1174145502 | Madison Elisabeth Nitsch | Specialist/Technologist | 825 Centennial Dr, Chadron, NE 69337-9400 | 2020-05-07 |
| 1639717135 | Leah A Frye | Pharmacist | 825 Centennial Dr, Chadron, NE 69337-9400 | 2019-12-15 |
| 1194370007 | Emily M Arterburn | Family Medicine | 825 Centennial Dr, Chadron, NE 69337-9400 | 2019-08-07 |
| 1619455946 | Chadron Medical Clinic PC | Family Medicine | 825 Centennial Dr, Chadron, NE 69337 | 2018-07-30 |
| 1619479698 | Kaelyse Noel Adler | Physician Assistant | 825 Centennial Dr, Chadron, NE 69337-9400 | 2018-03-06 |
| 1992217988 | Aimy Irenaeia Mahony | Family Medicine | 825 Centennial Dr, Chadron, NE 69337-9400 | 2017-10-30 |
| 1326593674 | Keith Bradley Blaylock | Physical Therapist | 825 Centennial Dr, Chadron, NE 69337-9400 | 2016-08-16 |
| 1427502897 | Eser Graham-marski | Physical Therapist | 825 Centennial Dr, Chadron, NE 69337-9400 | 2016-08-15 |
| 1174076657 | Sarah Wirth | Physical Therapy Assistant | 825 Centennial Dr, Chadron, NE 69337-9400 | 2016-08-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720507759 | Tracey Linn Wilson | Case Manager/Care Coordinator | 300 Shelton Street, Chadron, NE 69337 | 2017-09-11 |
| 1962668491 | Mental Health Care Assoc | Counselor | 343 Chadron Ave, Chadron, NE 69337 | 2008-08-04 |
| 1396901898 | Desiree Dawn Moreland | Pharmacist | 825 Centennial Drive, Chadron, NE 69337 | 2008-08-04 |
| 1336360684 | Joan M. Yekel | Counselor | 651 West 4th Street, Chadron, NE 69337 | 2007-05-02 |
| 1003030065 | Sonja Lynne Dressel | Counselor | 301 West 2nd St, Chadron, NE 69337 | 2007-04-12 |
| 1689798308 | Rebecca Ann Brost | Counselor | 301 West 2nd Street, Chadron, NE 69337 | 2007-03-19 |
| 1679638472 | Teena Ionne Kenrick | Counselor | 318 Shelton St, Chaoron, NE 69337 | 2006-12-22 |
| 1861560666 | Margaret K Griffith | Counselor | 327 Ann St, Chadron, NE 69337 | 2006-12-01 |
| 1386715654 | Affinity Therapy Associates LLC | Counselor | 327 Ann Street, Chadron, NE 69337 | 2006-11-10 |
| 1093724650 | Apria Healthcare LLC | Durable Medical Equipment & Medical Supplies | 625 West 3rd Street, Chadron, NE 69337 | 2006-08-05 |
| Find all providers in zip 69337 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| 1194202358 | Lmmc Lincoln, LLC | General Practice | 300 N 44th St Ste 102, Lincoln, NE 68503-3415 | 2018-07-20 |
| 1649629478 | Marathon Health, Inc. | General Practice | 108 West 17th Street, C/o Cargill Employee Health Center, Schuyler, NE 68661-1304 | 2016-06-13 |
| 1356605117 | Laura Marie Peterson | General Practice | 8330 Cheney Ridge Rd Apt 439, Lincoln, NE 68516-3820 | 2012-06-26 |
| 1013283431 | Daniel J Gross | General Practice | 1501 Jackson St Ste 100, Omaha, NE 68102-3146 | 2012-03-29 |
| 1043583560 | Virgil V Ottun | General Practice | 81084 Round Valley Rd, Sargent, NE 68874-3119 | 2012-02-14 |
| 1255644787 | Joseph Kennedy Costello Iv | General Practice | 224 N. 49th St. #4a, Omaha, NE 68132 | 2010-07-26 |
| 1326369075 | Gbgh | General Practice | 12309 Gold Street, Omaha, NE 68144-2760 | 2010-06-17 |
| 1477875649 | James Bane | General Practice | 11106 N 61st St, Omaha, NE 68152-1470 | 2010-02-15 |
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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.