Basic Information
| Provider Information | |||||||||
| NPI: | 1851340525 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STRASBURGER | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | EDWIN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7121 STEPHANIE LN | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685165359 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024660100 | ||||||||
| FaxNumber: | 4024660458 | ||||||||
| Practice Location | |||||||||
| Address1: | 7121 STEPHANIE LN | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685165359 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024660100 | ||||||||
| FaxNumber: | 4024660458 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2006 | ||||||||
| LastUpdateDate: | 09/02/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XX0005X | 20145 | NE | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine |
ID Information
| ID | Type | State | Issuer | Description | 209332006 | 05 | MO | MEDICAID | 47070309913 | 05 | NE | MEDICAID |