Basic Information
| Provider Information | |||||||||
| NPI: | 1740221969 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCCARTHY | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | ARTHUR | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8005 FARNAM DR STE 305 | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681143426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4023904111 | ||||||||
| FaxNumber: | 4023998455 | ||||||||
| Practice Location | |||||||||
| Address1: | 8005 FARNAM DR STE 305 | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681143426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4023904111 | ||||||||
| FaxNumber: | 4023998455 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2006 | ||||||||
| LastUpdateDate: | 08/04/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 17433 | NE | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XS0106X | MD-23135 | IA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery | 2086S0105X | 17433 | NE | N | Allopathic & Osteopathic Physicians | Surgery | Surgery of the Hand | 207XS0106X | 17433 | NE | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery | 2086S0105X | MD-23135 | IA | N | Allopathic & Osteopathic Physicians | Surgery | Surgery of the Hand |
ID Information
| ID | Type | State | Issuer | Description | 14779 | 01 | NE | MIDLANDS CHOICE | OTHER | 09-00182 | 01 | NE | SHARE ADVANTAGE /MERCY RD | OTHER | 09-01138 | 01 | NE | SHARE ADVANTAGE/LAKESIDE | OTHER | 47063010113 | 05 | NE | MEDICAID | 00435 | 01 | NE | BCBS OF NEBRASKA | OTHER | 0909598 | 05 | IA | MEDICAID |