Basic Information
| Provider Information | |||||||||
| NPI: | 1942942909 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | NEXTCARE NEBRASKA PROVIDERS LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | NEXTCARE URGENT CARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2550 N THUNDERBIRD CIR STE 303 | ||||||||
| Address2: | |||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852151219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8887058558 | ||||||||
| FaxNumber: | 4807760025 | ||||||||
| Practice Location | |||||||||
| Address1: | 110 N 66TH ST | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685052402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4023258950 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2022 | ||||||||
| LastUpdateDate: | 09/07/2022 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | SODERBERG | ||||||||
| AuthorizedOfficialFirstName: | BERNICE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | VP OF REVENUE CYCLE MANAGEMENT | ||||||||
| AuthorizedOfficialTelephone: | 8887058558 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 08/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine | 261QU0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.