STATE OF NEBRASKA DEPT OF ADMIN SERVICES , NPI 1790706034 — CENTRAL NEBRASKA VETERANS HOME in KEARNEY (NE)

NPI 1790706034

13+ Years Experience Organization

STATE OF NEBRASKA DEPT OF ADMIN SERVICES

Other organization name: CENTRAL NEBRASKA VETERANS HOME. Name type code: 3 - doing business as (d/b/ a) name.

07/22/2006
PROVIDER ENUMERATION DATE
12/14/2018
LAST UPDATE DATE
1790706034
NPI NUMBER

About STATE OF NEBRASKA DEPT OF ADMIN SERVICES

Parent organization: STATE OF NEBRASKA DEPT OF ADMIN SERVICES.

STATE OF NEBRASKA DEPT OF ADMIN SERVICES is a provider established in KEARNEY, NE. The NPI number of STATE OF NEBRASKA DEPT OF ADMIN SERVICES is 1790706034 and was assigned on 07/22/2006. The practitioners primary taxonomy code is: 310400000X with license number: ALF293 NE .

Mailing address

  • City: LINCOLN
  • State: NE
  • Postal code: 685095112
  • Phone: 4024711831
  • Fax: 4027421142
  • Address: PO BOX 95112

Primary Practice Address

  • Region : KEARNEY, NE
  • NPI : 1790706034
  • Phone : 4024711831
  • Fax : 4027421142
  • Postalcode : 688474116
  • Address : 4510 E 56TH ST

Provider taxonomy - Assisted Living Facility

  • Taxonomy code: 310400000X
  • License number: ALF293
  • License state: NE

The taxonomy is not the primary taxonomy.

Taxonomy description: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Healthcare provider taxonomy #2 - Skilled Nursing Facility

  • Taxonomy code: 314000000X
  • License number: 374004
  • License state: NE

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

Taxonomy description: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

Contacts:

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  • STATE OF NEBRASKA DEPT OF ADMIN SERVICES
  • Address : 4510 E 56TH ST
  • Region : KEARNEY, NE
  • NPI : 1790706034
  • Phone : 4024711831
  • Fax : 4027421142
  • Postalcode : 688474116

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 4024711831
  • Title or position : HEALTH INFORMATION MANAGER

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

Field Name Value
Provider First Line Business Practice Location Address4510 E 56TH ST
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 NameKEARNEY
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 Code688474116
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 Number4024711831
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number4027421142
The fax number associated with the location address of the provider being identified.
NPI1790706034
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1310400000X
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
Provider Enumeration Date07/22/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated12/14/2018
The date that a record was last updated or changed.
Entity TypeOrganization
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).
Is Organization SubpartY
The "Is the organization a subpart?" question must be answered. If the organization is a subpart, the Parent Organization Legal Business Name (LBN) and Parent Organization Taxpayer Identification Number (TIN) fields must be completed. The Parent Organization LBN and TIN fields can only be completed if the answer to the subpart question is Yes. Many organization health care providers who apply for NPIs are not legal entities themselves but are parts of other organization health care providers that are legal entities (the "parents"). Here are three examples of organization health care providers that may be considered subparts and may apply for NPIs if so directed by their "parents": (1) The psychiatric unit in a hospital is not a legal entity but is part of the hospital (the "parent"), which is a legal entity. The legal entity must obtain an NPI. The psychiatric unit is an example of a subpart that could have its own NPI if the hospital determines that it should. (2) A group practice that is not a sole proprietorship has a main location and could have other offices in different locations, but each office is not a separate legal entity; instead, each office is part of the corporation (the "parent") which is a legal entity. The offices are examples of subparts that could have their own NPIs if the main location determines that they should. (3) A pharmacy fills prescriptions for patients whose physicians have prescribed medications for them and may also rent or sell durable medical equipment to patients whose physicians have ordered such equipment for them. Neither the pharmacy line of business nor the DME line of business represent legal entities; instead, both lines of business are part of an organization (the "parent") that is a legal entity. Each line of business represents a different Healthcare Provider Taxonomy or area of specialization that often submits its own electronic claims to health plans. The "parent"-we don"t know who the parent is in this example-must ensure that each subpart that submits its own claims to health plans has its own NPI.
Provider Organization Name (Legal Business Name)STATE OF NEBRASKA DEPT OF ADMIN SERVICES
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 Other Organization NameCENTRAL NEBRASKA VETERANS HOME
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code3
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing AddressPO BOX 95112
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 NameLINCOLN
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 Code685095112
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 Number4024711831
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 Number4027421142
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".
Authorized Official Last NameHUNT
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameCLARISSA
The first name of the authorized official
Authorized Official Title or PositionHEALTH INFORMATION MANAGER
The title or position of the authorized official
Authorized Official Telephone Number4024711831
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1310400000X
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 1Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
Provider License Number 1ALF293
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 1NE
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 2314000000X
Healthcare Provider Taxonomy 2Skilled Nursing Facility
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
Provider License Number 2374004
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.
X

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