DR. GARY DEAN VOLENTINE MD, NPI 1487651519 — OMAHA (NE)

NPI 1487651519

14+ Years Experience Individual

DR. GARY DEAN VOLENTINE MD

07.05.2005
PROVIDER ENUMERATION DATE
07.03.2012
LAST UPDATE DATE
1487651519
NPI NUMBER

About DR. GARY DEAN VOLENTINE

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

DR. GARY DEAN VOLENTINE is a provider established in OMAHA, NE. The NPI number of DR. GARY DEAN VOLENTINE is 1487651519 and was assigned on 07.05.2005. The practitioners primary taxonomy code is: 207RG0100X with license number: 21661 IA .

Mailing address

  • City: OMAHA
  • State: NE
  • Postal code: 681988102
  • Phone: 4025599800
  • Fax: 4025599416
  • Address: 988102 NEBRASKA MEDICAL CTR

Primary Practice Address

  • Region : OMAHA, NE
  • NPI : 1487651519
  • Phone : 4025599800
  • Fax : 4025599416
  • Postalcode : 681988102
  • Address : 988102 NEBRASKA MEDICAL CTR

Additional identifiers

  • Identifier: 3941278
  • Code / Type : 5 - MEDICAID
  • Identifier state : IA

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Additional identifiers # 2

  • Identifier: 10026059800
  • Code / Type : 5 - MEDICAID
  • Identifier state : NE

Provider taxonomy - Internal Medicine

  • Taxonomy code: 207RG0100X
  • License number: 21661
  • License state: IA

The taxonomy is not the primary taxonomy.

Taxonomy description: An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

Healthcare provider taxonomy #2 - Internal Medicine

  • Taxonomy code: 207RG0100X
  • License number: 15169
  • License state: NE

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

Contacts:

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  • DR. GARY DEAN VOLENTINE MD
  • Address : 988102 NEBRASKA MEDICAL CTR
  • Region : OMAHA, NE
  • NPI : 1487651519
  • Phone : 4025599800
  • Fax : 4025599416
  • Postalcode : 681988102

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address988102 NEBRASKA MEDICAL CTR
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameOMAHA
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameNE
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code681988102
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number4025599800
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number4025599416
The fax number associated with the location address of the provider being identified.
NPI1487651519
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1207RG0100X
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
Provider Enumeration Date07.05.2005
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.03.2012
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)DR. GARY DEAN VOLENTINE
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address988102 NEBRASKA MEDICAL CTR
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameOMAHA
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameNE
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code681988102
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number4025599800
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number4025599416
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #1207RG0100X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Internal Medicine
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
Provider License Number 121661
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1IA
Healthcare Provider Primary Taxonomy Switch 1N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 2207RG0100X
Healthcare Provider Taxonomy 2Internal Medicine
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
Provider License Number 215169
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 2NE
Healthcare Provider Primary Taxonomy Switch 2Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Other Provider Identifier 13941278
Other Provider Identifier #1
Other Provider Identifier Type 15
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1IA
Other Provider Identifier State #1
Other Provider Identifier 210026059800
Other Provider Identifier #2
Other Provider Identifier Type 25
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 2NE
Other Provider Identifier State #2
Provider Gender CodeM
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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