LINCOLN PERFORMANCE AND SPORTS MEDICINE, LLC (NPI# 1891341467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891341467 |
| Entity Type | Organization |
| Organization Name | LINCOLN PERFORMANCE AND SPORTS MEDICINE, LLC |
| Practice Address |
9100 Andermatt Dr Ste 2 Lincoln NE 68526-6700 |
| Practice Telephone | 4024807070 |
| Mailing Telephone | 4024807070 |
| Enumeration Date | 2019-08-10 |
| Last Update Date | 2019-11-07 |
| Authorized Official Name | DR. TYLER MARK IDEUS (PHYSICIAN) |
| Authorized Official Telephone | 4022392298 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | Chiropractic Providers |
| Street Address |
9100 ANDERMATT DR STE 2 |
| City | LINCOLN |
| State | NE |
| Zip Code | 68526-6700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033188321 | Linda Kroeger | Family Medicine | 9100 Andermatt Dr Ste 2, Lincoln, NE 68526-6700 | 2006-03-17 |
| 1922626225 | Audrey Pascal Pika | Family Medicine | 9100 Andermatt Dr Ste 2, Lincoln, NE 68526-6700 | 2020-07-13 |
| 1043702293 | Chelsy R Binkley | Registered Nurse | 9100 Andermatt Dr Ste 2, Lincoln, NE 68526-6700 | 2018-06-04 |
| 1316469380 | Stacy Ann Froehlich | Family Medicine | 9100 Andermatt Dr Ste 2, Lincoln, NE 68526-6700 | 2017-07-12 |
| 1023407350 | Kylie Parshall | Family Medicine | 9100 Andermatt Dr Ste 2, Lincoln, NE 68526-6700 | 2015-01-09 |
| 1174827224 | Tyler Mark Ideus | Chiropractor | 9100 Andermatt Dr Ste 2, Lincoln, NE 68526-6700 | 2011-01-04 |
| 1881827129 | Jacqueline Anne Stewart | Family Medicine | 9100 Andermatt Dr Ste 2, Lincoln, NE 68526-6700 | 2009-09-03 |
| 1790814630 | Timothy C Kuntz | Family Medicine | 9100 Andermatt Dr Ste 2, Lincoln, NE 68526-6700 | 2007-03-05 |
| 1417908666 | Pine Lake Health LLC | Durable Medical Equipment & Medical Supplies | 9100 Andermatt Dr Ste 2, Lincoln, NE 68526-6700 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881251189 | Jennifer Demesquita Harrison | Nurse Practitioner | Alivation Health, 8550 Cuthills Circle, Lincoln, NE 68526 | 2019-05-22 |
| 1265954648 | Grant Essink | Dentist | 7822 South 96th Bay, Lincoln, NE 68526 | 2017-07-07 |
| 1528405719 | Charles Weston Whitten | Anesthesiology | 4546 S 86th St Ste B, Lincoln, NE 68526 | 2013-05-28 |
| 1912055112 | Hemantha Kumar Koduri | Internal Medicine | 4445 S 86th St Ste 100, Lincoln, NE 68526 | 2007-01-06 |
| 1306909585 | Melanie J Fulton | Dentist | 4525 So 86th, Ste A, Lincoln, NE 68526 | 2006-12-18 |
| 1952359812 | Kathleen Ann Packard | Pharmacist | 7440 S 91st Street, Lincoln, NE 68526 | 2006-05-04 |
| 1861932444 | Amber Walter | Advanced Practice Midwife | 9110 Andermatt Drive, Ste 2, Lincoln, NE 68526 | 2017-03-02 |
| 1801205794 | Danielle Melissa Kollasch | Physician Assistant | 8550 Cuthills Circle, Lincoln, NE 68526 | 2014-08-05 |
| 1891132700 | Michaela Irene Kadavy | Counselor | 4545 S 86th St, Lincoln, NE 68526 | 2013-05-31 |
| 1578827614 | Sams West Inc | Technician/Technologist | 8480 Andermatt Dr, Lincoln, NE 68526 | 2012-07-03 |
| Find all providers in zip 68526 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982228524 | Denison J Salisbury | Chiropractor | 3121 South 11th St, Lincoln, NE 68502 | 2020-05-29 |
| 1124642863 | The Body Lab, LLC | Chiropractor | 1415 Dahlberg Dr Ste A, Lincoln, NE 68512-9266 | 2020-05-28 |
| 1447879515 | Nodak Chiropractic and Acupuncture LLC | Chiropractor | 2730 Paintball Way Bldg B, Lincoln, ND 58504-2503 | 2020-04-09 |
| 1235776550 | Healthfirst Lincoln Inc | Chiropractor | 2200 N Kickapoo St Ste 2, Lincoln, IL 62656-1390 | 2019-12-05 |
| 1447712757 | Novo Chiropractic LLC | Chiropractor | 8601 S 30th St Ste 108, Lincoln, NE 68516-5957 | 2019-04-04 |
| 1003380775 | Dustin Hadley Smith | Chiropractor | 4220 Lucile Dr Ste 2, Lincoln, NE 68506-6004 | 2019-01-16 |
| 1720569866 | Zoann Alexis Mader | Chiropractor | 7555 S 57th St Ste 2, Lincoln, NE 68516-6663 | 2018-08-27 |
| 1639657240 | Lindsey Christine Decker | Chiropractor | 292 S 65 Hwy, Lincoln, MO 65338-2587 | 2018-08-06 |
| 1679050371 | Troy Charles Hayes | Chiropractor | 8550 Andermatt Dr Ste 2, Lincoln, NE 68526-9781 | 2018-07-25 |
| 1235616442 | Vinay Panchal | Chiropractor | 3121 S 11th St, Lincoln, NE 68502-4416 | 2018-07-20 |
| Find all providers in LINCOLN | ||||
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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.