MR. TIMOTHY BLECHA (NPI# 1790777936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790777936 |
| Entity Type | Individual |
| Full Name | MR. TIMOTHY BLECHA |
| Credential | MD |
| Practice Address |
525 E 11th St Superior NE 68978-1101 |
| Mailing Address |
Po Box 407 525 E 11th St Superior NE 68978-0407 |
| Practice Telephone | 4028794781 |
| Practice Fax Number | 4028793365 |
| Mailing Telephone | 4028794781 |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2020-09-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 15972 | NE | Other Service Providers |
| N | 207P00000X | Emergency Medicine | 15972 | NE | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 15972 | NE | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | BLUE CROSS BLUE SHIELD NE | 32279 | 01 |
| NE | 1790777936 | 05 |
| Street Address |
525 E 11TH ST |
| City | SUPERIOR |
| State | NE |
| Zip Code | 68978-1101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568756609 | Alisha Fangmeyer | Nurse Practitioner | 525 E 11th St, Superior, NE 68978-1101 | 2011-06-07 |
| 1245552140 | Matthew Gatlin | Physician Assistant | 525 E 11th St, Superior, NE 68978-1101 | 2010-02-18 |
| 1073590626 | Brodstone Memorial Hospital | Physician Assistant | 525 E 11th St, Superior, NE 68978-1101 | 2005-12-26 |
| 1578540126 | Robert G Leibel | Family Medicine | 525 E 11th St, Superior, NE 68978-1101 | 2005-12-26 |
| 1295712842 | Julie A Theis | Family Medicine | 525 E 11th St, Superior, NE 68978-1101 | 2005-12-26 |
| 1831176486 | Jason G Hass | Physician Assistant | 525 E 11th St, Superior, NE 68978-1101 | 2005-12-26 |
| 1477530020 | Teresa B Frahm | Nurse Practitioner | 525 E 11th St, Superior, NE 68978-1101 | 2005-12-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144475740 | Superior Vision PC | Eyewear Supplier (Equipment, not the service) | 358 Central Ave, Superior, NE 68978 | 2008-11-24 |
| 1427234160 | Elinor Lynn Wilton | Speech-Language Pathologist | 4034 Road C, Superior, NE 68978 | 2008-01-11 |
| 1780720904 | Sharon Greenwood | Counselor | 344 North Dakota, Superior, NE 68978 | 2007-01-29 |
| 1780776583 | South Central Behavioral Services | Clinic/Center | 520 East 10th Street, Broadstone Memorial Hospital, Superior, NE 68978 | 2006-09-29 |
| 1780804112 | Terry Dale Kermoade | Pharmacist | 520 East 10th Street, Superior, NE 68978 | 2007-04-26 |
| 1033288097 | Peggy Ann Meyer | Counselor | 520 E 10th St, Superior, NE 68978 | 2006-11-06 |
| 1013024215 | Steve Abe Fox | Nurse Anesthetist, Certified Registered | 1324 Montana St, Superior, NE 68978-1038 | 2006-08-24 |
| 1154702611 | Kingswood Court Assisted Living, LLC | Assisted Living Facility | 1005 Idaho St, Superior, NE 68978-1103 | 2015-06-10 |
| 1477637619 | Brodstone Memorial Hospital | Home Health | 1050 Washington St, Superior, NE 68978-1149 | 2006-10-24 |
| 1144496589 | Positive Solutions, Inc | Social Worker | 1050 Washington St, Superior, NE 68978-1149 | 2008-05-06 |
| Find all providers in zip 68978 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982900106 | Tina Lynn Snyder | Family Medicine | 3141 Huron Peak Ave, Superior, CO 80027-4628 | 2011-02-04 |
| 1194046730 | Rita Caroline Schaffner | Family Medicine | 500 Discovery Pkwy Ste 150, Superior, CO 80027-8645 | 2010-06-17 |
| 1063586667 | Linda Elizabeth Sasha Stiles | Family Medicine | 1335 S Mesa Ct, Superior, CO 80027-8058 | 2006-11-17 |
| 1760564942 | James Henry Dobis | Family Medicine | 3520 Tower Avenue, Twin Ports Va Outpatient Clinic, Superior, WI 54880 | 2006-10-19 |
| 1760449763 | Lauren Elizabeth Giammar | Family Medicine | 109 N 28th St E, Superior, WI 54880-6548 | 2006-04-26 |
| 1447251319 | Gregory S Houlihan | Family Medicine | 1208 6th Ave E, Superior, MT 59822-9618 | 2005-08-02 |
| 1649272873 | David G Apple | Family Medicine | 3 Superior Dr Ste 100b, Superior, CO 80027-8653 | 2005-06-01 |
| 1306486592 | Twin Ports Health Solutions Sc | Family Medicine | 1728 Tower Ave, Superior, WI 54880-2543 | 2020-01-15 |
| 1699328120 | Elizabeth Fanning | Family Medicine | 400 S Mccaslin Blvd, Superior, CO 80027-9731 | 2019-07-23 |
| 1821518267 | Ryan Morgan | Family Medicine | 3500 Tower Ave, Superior, WI 54880-4491 | 2017-06-27 |
| Find all providers in SUPERIOR | ||||
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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.