SANTA MARIANITA CLINIC, INC (NPI# 1477586139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477586139 |
| Entity Type | Organization |
| Organization Name | SANTA MARIANITA CLINIC, INC |
| Practice Address |
1112 Verges Ave Norfolk NE 68701-3853 |
| Practice Telephone | 4023798717 |
| Practice Fax Number | 4023790447 |
| Mailing Telephone | 4023798717 |
| Mailing Fax Number | 4023790447 |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2012-04-27 |
| Authorized Official Name | MR. RODRIGO GOMEZ-CORDERO (OWNER) |
| Authorized Official Telephone | 4023798717 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
15892 | NE | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | BLUE CROSS BLUE SHIELD | 06484 | 01 |
| NE | MIDLANDS CHOICE | 2407 | 01 |
| Street Address |
1112 VERGES AVE |
| City | NORFOLK |
| State | NE |
| Zip Code | 68701-3853 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750846374 | Josie Lanai Clark | Physician Assistant | 1112 Verges Ave, Norfolk, NE 68701-3853 | 2019-02-07 |
| 1679047955 | Nebraska Health and Wellness Clinic LLC | Clinic/Center | 1112 Verges Ave, Norfolk, NE 68701-3853 | 2019-01-19 |
| 1760990105 | Jose Luis Nuno | Physician Assistant | 1112 Verges Ave, Norfolk, NE 68701-3853 | 2018-01-19 |
| 1144384611 | Rodrigo Gomez Cordero | Surgery | 1112 Verges Ave, Norfolk, NE 68701 | 2006-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700408465 | Women's Empowering Life Line, Inc. | Substance Abuse Rehabilitation Facility | 200 South 13th St, Norfolk, NE 68701 | 2020-05-15 |
| 1093297103 | Nicole Marie Owens | Physician Assistant | 2701 W. Norfolk Ave, Norfolk, NE 68701 | 2018-09-05 |
| 1326535410 | Healing Hands of Nebraska, PC | Otolaryngology | Sunset Plaza, 1700 Market Lane, Suite 410, Norfolk, NE 68701 | 2018-04-16 |
| 1356864995 | Nmg LLC | Family Medicine | 301 North 27th Street Suite 1, Norfolk, NE 68701 | 2017-07-25 |
| 1609396423 | Alison Erin Pfeifer | Physical Therapy Assistant | 1220 W Benjamin Ave #4, Norfolk, NE 68701 | 2017-06-22 |
| 1568996148 | Xanat Naranjo | Registered Nurse | 105 E. Norfolk Ave, Norfolk, NE 68701 | 2017-04-20 |
| 1194259945 | Angela Cornett | Licensed Practical Nurse | 105 E. Norfolk, Norfolk, NE 68701 | 2017-04-19 |
| 1669906400 | Melodie Ann Nielsen | Registered Nurse | 105 East Norfolk Ave, Norfolk, NE 68701 | 2017-04-19 |
| 1528519543 | Women's Empowering Life Line | Substance Abuse Rehabilitation Facility | 910 West Park Avenue, Norfolk, NE 68701 | 2016-10-14 |
| 1174983100 | Brooke Cemper | Nurse Practitioner | 2701 West Norfolk Ave, Norfolk, NE 68701 | 2016-03-03 |
| Find all providers in zip 68701 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255773693 | Nebraska Vein Care P.C. | Clinic/Center | 1414 North 13th St, Norfolk, NE 68701-2669 | 2013-07-26 |
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|---|---|---|---|---|
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| 1649455643 | Joshua Philip Havens | Clinic/Center | 804 S. 52nd, Omaha, NE 68106 | 2008-01-08 |
| 1447315825 | Wellness Partners, LLC | Clinic/Center | 106 W. 3rd St., Mccook, NE 69001 | 2006-12-26 |
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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.