Julie A Theis (NPI# 1295712842, PAC ID# 0042247439) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1295712842 |
| PAC ID by PECOS | 0042247439 |
| Professional Enrollment ID | I20050718000456 |
| Full Name | Julie A Theis |
| Organization Legal Name | BRODSTONE MEMORIAL HOSPITAL |
| Address |
520 E 10th St Superior NE 68978-1225 |
| Phone Number | 4028793281 |
| Gender | F |
| Credential | MD |
| Medical School | UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE |
| Graduation Year | 2000 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 4082513015 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 281315 | BRODSTONE MEMORIAL HOSP |
| 280013 | THE NEBRASKA MEDICAL CENTER |
| 281361 | LEXINGTON REGIONAL HEALTH CENTER |
| Address | Phone | Organization |
|---|---|---|
| 520 E 10th St, Superior, NE 68978-1225 | 4028793281 | BRODSTONE MEMORIAL HOSPITAL |
| Organization Legal Name | BRODSTONE MEMORIAL HOSPITAL |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Alisha Fangmeyer | Nurse Practitioner | Brodstone Memorial Hospital | 520 E 10th St, Superior, NE 68978-1225 |
| Robert G Leibel | Family Medicine | Brodstone Memorial Hospital | 520 E 10th St, Superior, NE 68978-1225 |
| Timothy D Blecha | Family Medicine | Brodstone Memorial Hospital | 520 E 10th St, Superior, NE 68978-1225 |
| Jason G Hass | Physician Assistant | Brodstone Memorial Hospital | 520 E 10th St, Superior, NE 68978-1225 |
| Street Address |
520 E 10TH ST |
| City | SUPERIOR |
| State | NE |
| Zip | 68978-1225 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Alisha Fangmeyer | Nurse Practitioner | Brodstone Memorial Hospital | 520 E 10th St, Superior, NE 68978-1225 |
| Robert G Leibel | Family Medicine | Brodstone Memorial Hospital | 520 E 10th St, Superior, NE 68978-1225 |
| Timothy D Blecha | Family Medicine | Brodstone Memorial Hospital | 520 E 10th St, Superior, NE 68978-1225 |
| Jason G Hass | Physician Assistant | Brodstone Memorial Hospital | 520 E 10th St, Superior, NE 68978-1225 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Holly L Beavers | Physical Therapy | Superior Physical Therapy LLC | 308 N Central Ave, Superior, NE 68978-1715 |
| Jeremy W Mcmeen | Optometry | 358 N Central Ave, Superior, NE 68978-1715 | |
| Bradley Jon Gardner | Physical Therapy | Superior Physical Therapy LLC | 308 N Central Ave, Superior, NE 68978-1715 |
| Peggy A Meyer | Clinical Social Worker | 317 N Central Ave, Superior, NE 68978-1737 |
| City | SUPERIOR |
| Zip Code | 68978 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | SUPERIOR + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Julie A Theis.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.