DR. PHILLIP LEE MICKELSEN (NPI# 1518960012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518960012 |
| Entity Type | Individual |
| Full Name | DR. PHILLIP LEE MICKELSEN |
| Credential | M.D. |
| Practice Address |
6420 56th Ave Kearney NE 68845-0380 |
| Practice Telephone | 3082242062 |
| Practice Fax Number | 8889745962 |
| Mailing Telephone | 3082242062 |
| Mailing Fax Number | 8889745962 |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2020-01-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207L00000X | Anesthesiology | 32312 | NE | Allopathic & Osteopathic Physicians |
| N | 207L00000X | Anesthesiology | 107063 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | PRONET / AETNA | 967331 | 01 |
| MN | MN MEDICAL LICENSE | 107063 | 01 |
| NM | BLUE CROSS BLUE SHEILD | NM009R60 | 01 |
| NM | 43227252 | 05 | |
| NM | 86929 | 05 | |
| AZ | 859457 | 05 |
| Street Address |
6420 56TH AVE |
| City | KEARNEY |
| State | NE |
| Zip Code | 68845-0380 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407465966 | Prairie Meadows Dental, PC | Clinic/Center | 1055 West 56th Street, Kearney, NE 68845 | 2020-07-30 |
| 1508408584 | Sandhills Oral & Facial Surgery LLC | Clinic/Center | 504 W 42nd Street, Kearney, NE 68845 | 2019-10-11 |
| 1699252395 | Lindustries, LLC | Clinic/Center | 4107 7th Avenue, Kearney, NE 68845 | 2018-07-25 |
| 1154846764 | Michele Ekberg | Speech-Language Pathologist | 76 Plaza Boulevard, Kearney, NE 68845 | 2017-08-04 |
| 1457721706 | Lesa Clifford | Speech-Language Pathologist | 4125 Summitt Rd, Kearney, NE 68845 | 2015-09-30 |
| 1154703353 | Andrew Michael Prososki | Family Medicine | 2403 West 47 Street Place, Kearney, NE 68845 | 2015-06-24 |
| 1710395561 | Justin Rethorst | Specialist/Technologist | 2810 West 35th St, Kearney, NE 68845 | 2014-07-24 |
| 1265877567 | Kearney Regional Medical Center LLC | General Acute Care Hospital | 804 22nd Avenue, Kearney, NE 68845 | 2013-05-01 |
| 1386906972 | Terry L. Dunlop | Counselor | 2315 W. 39th St., Suite 109, Kearney, NE 68845 | 2012-06-11 |
| 1437431913 | Sarah Winfield Thibault | Counselor | 3532 West Capital Ave, Grand Island, NE 68845 | 2011-09-12 |
| Find all providers in zip 68845 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255964771 | Stone Ridge Anesthesia Associates, LLC | Anesthesiology | 920 E 56th St Ste D, Kearney, NE 68847-8628 | 2020-02-13 |
| 1942533252 | David Mcconnell, Md, LLC | Anesthesiology | 33 Red Fox Ln, Kearney, NE 68845-7611 | 2009-09-18 |
| 1407941982 | Pamela Sue Mckeag | Anesthesiology | 920 E 56th St Ste C2, Kearney, NE 68847-8628 | 2006-10-03 |
| 1023122272 | Merlin J Wehling | Anesthesiology | 804 22nd Ave, Kearney, NE 68845-2234 | 2006-08-17 |
| 1003393703 | Adetinuwe Majekodunmi | Anesthesiology | 10 E 31st St, Kearney, NE 68847-2908 | 2018-07-25 |
| 1326296807 | Jesse Pandorf | Anesthesiology | 10 E 31st St, Kearney, NE 68847-2926 | 2008-09-08 |
| 1013120492 | Robert R Shaffer | Anesthesiology | 115 E 52nd St, Kearney, NE 68847 | 2007-05-08 |
| 1548355829 | Amy Marie Clark | Anesthesiology | 804 22nd Ave, Sonno Anesthesia PC, Kearney, NE 68845-0380 | 2006-10-04 |
| 1629182936 | Doctors Anesthesia Group, P.C. | Anesthesiology | 115 E 52nd St, Kearney, NE 68847-0502 | 2006-08-17 |
| 1730293952 | Dennis L Edwards | Anesthesiology | 115 E 52nd St, Kearney, NE 68847-0502 | 2006-08-17 |
| Find all providers in KEARNEY | ||||
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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.