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WEDGEWOOD LEGACY MEDICAL P.C. NPI 1053347187


NPI Information

NPI: 1053347187
Provider Name: WEDGEWOOD LEGACY MEDICAL P.C.
Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
8055 O ST
STE S-109
LINCOLN, NE
ZIP 68510
Phone: (402) 489-8821
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WEDGEWOOD LEGACY MEDICAL P.C. is an internal medicine in Lincoln, NE. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. WEDGEWOOD LEGACY MEDICAL P.C. NPI is 1053347187. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

8055 O ST
STE S-109
LINCOLN, NE
ZIP 68510-564
Phone: (402) 489-8821
Fax: (402) 489-0733

The provider's authorized official is James A. Fosnaugh .
The authorized official title is Md and has the following contact phone number (402) 489-0334.

The enumeration date for this NPI number is 6/23/2006 and was last updated on 5/15/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
110025176100MEDICAIDNEBRASKA
21902OTHERNEBRASKABCBS
3DC8274MEDICARE PIN
4099567MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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