FREMONT PEDIATRIC, ADOLESCENT AND YOUNG ADULT MEDICINE, LLC. (NPI# 1558550368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558550368 |
| Entity Type | Organization |
| Organization Name | FREMONT PEDIATRIC, ADOLESCENT AND YOUNG ADULT MEDICINE, LLC. |
| Other Organization Name | KID CARE |
| Practice Address |
220 E 22nd St Fremont NE 68025-2606 |
| Practice Telephone | 4027275500 |
| Practice Fax Number | 4027276047 |
| Mailing Telephone | 4027275500 |
| Mailing Fax Number | 4027276047 |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2014-08-01 |
| Authorized Official Name | DR. TERRY N WOOLDRIDGE (OWNER) |
| Authorized Official Telephone | 4027275500 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 18159 | NE | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Kid Care | Doing Business As Name - Organization |
| Street Address |
220 E 22ND ST |
| City | FREMONT |
| State | NE |
| Zip Code | 68025-2606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750488284 | Terry Nye Wooldridge | Pediatrics | 220 E 22nd St, Fremont, NE 68025-2606 | 2006-09-19 |
| 1114351558 | Amanda Nicole Esterling | Nurse Practitioner | 220 E 22nd St, Fremont, NE 68025-2606 | 2013-08-21 |
| 1457447013 | Thomas William Homan | Physician Assistant | 220 E 22nd St, Fremont, NE 68025-2093 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710456934 | Methodist Fremont Health | Pharmacy | 450 E 23rd, Fremont, NE 68025 | 2018-11-16 |
| 1811484546 | Cynthia Jane Cusick | Social Worker | 748 North Main Street, Fremont, NE 68025 | 2018-04-18 |
| 1891298196 | Hergenrader Dental Rehab PC | Dentist | 3102 East Elk Lane, Fremont, NE 68025 | 2018-03-13 |
| 1982142857 | Paula Y. Walla | Speech-Language Pathologist | 130 E. 9th St., Fremont, NE 68025 | 2017-02-10 |
| 1619326709 | Debra Baker | Nurse Practitioner | 3140 Elk Ln Ste 600, Fremont, NE 68025 | 2016-06-09 |
| 1912368069 | Nicole Henkel | Occupational Therapist | 450 East 23rd, Fremont, NE 68025 | 2016-03-17 |
| 1265818017 | Orchid of Hope Counseling | Exclusive Provider Organization | 1919 North Broad Street, Fremont, NE 68025 | 2015-08-04 |
| 1265770366 | James N Orr | Pharmacist | 840 E 23 St, Fremont, NE 68025 | 2013-01-24 |
| 1902156086 | Penelope Anastasia Stoll | Speech-Language Pathologist | Nye Legacy, 3210 N. Clarkson St, Fremont, NE 68025 | 2012-09-14 |
| 1144582685 | Diane Marie Gehring | Case Management | 105 East 12th Street, Fremont, NE 68025 | 2012-06-11 |
| Find all providers in zip 68025 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295349132 | Guiding Hands Rehab, Inc. | Clinic/Center | 606 W State St, Fremont, OH 43420-2534 | 2020-09-08 |
| 1518367846 | Golder Stone International, Inc | Clinic/Center | 46249 Warm Springs Blve Suite 1, Fremont, CA 94539 | 2014-08-22 |
| 1356611636 | Dr. Richard K. Skala Dc Qme Chiropractic Corporation | Clinic/Center | 5500 Stewart Ave, #113, Fremont, CA 94538-3100 | 2012-01-04 |
| 1962687566 | Columbia Asthma & Allergy Clinic | Clinic/Center | 3448 Mowry Ave, Fremont, CA 94538 | 2008-01-02 |
| 1053435248 | California Cardiovascular Consultant Medical Associates | Clinic/Center | 1900 Mowry Ave Ste 309, Fremont, CA 94538-1722 | 2007-03-16 |
| 1780292870 | American Current Care of California | Clinic/Center | 3161 Walnut Ave, Fremont, CA 94538-2216 | 2020-07-15 |
| 1225561103 | Lara T. San Pedro, Psy.d., A Psychological Corporation | Clinic/Center | 39210 State St, Suite 200, Fremont, CA 94538-1456 | 2017-04-06 |
| 1750749891 | Hoda Spine & Msk Pain Company, Inc | Clinic/Center | 1860 Mowry Ave, Ste. 401, Fremont, CA 94538-1730 | 2016-02-03 |
| 1396053294 | Act Acupuncture Clinic Corp | Clinic/Center | 40788 Fremont Blvd, Fremont, CA 94538-4373 | 2010-09-14 |
| 1356664072 | Fremont Chiropractic Clinic PC | Clinic/Center | 415 E 23rd St, Suite 201, Fremont, NE 68025-2393 | 2010-03-09 |
| Find all providers in FREMONT | ||||
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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.