1518076884 NPI number — DR. RHONDEL J MCCANN MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518076884 NPI number — DR. RHONDEL J MCCANN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCCANN
Provider First Name:
RHONDEL
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518076884
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/05/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6753
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LINCOLN
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68506-0753
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-488-3766
Provider Business Mailing Address Fax Number:
402-483-2152

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2300 S 16TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LINCOLN
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68502-3704
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-488-3766
Provider Business Practice Location Address Fax Number:
402-483-2152
Provider Enumeration Date:
08/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208100000X , with the licence number:  NE22757 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2300173 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 577106 . This is a "IOWA MEDICAID" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 03603 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 209366806 . This is a "MISSOURI MEDICAID" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 7709850 . This is a "SOUTH DAKOTA MEDICAID" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 243230 . This is a "MIDLANDS CHOICE" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 200336140A . This is a "KANSAS MEDICAID" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 2300173 . This is a "AMERICHOICE" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 270890 . This is a "COVENTRY OF NEBRASKA" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: P00155509 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com