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SUPERIOR STREET FAMILY PHYSICIANS NPI 1255400206


NPI Information

NPI: 1255400206
Provider Name: SUPERIOR STREET FAMILY PHYSICIANS

Doing Business As: FALLBROOK FAMILY HEALTH CENTER

Classification: Family Medicine - 207QA0505X
Entity Type: Organization

Specialization: Adult Medicine

Address:
755 FALLBROOK BLVD
SUITE 100
LINCOLN, NE
ZIP 68521
Phone: (402) 441-3575
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SUPERIOR STREET FAMILY PHYSICIANS is an adult medicine family medicine in Lincoln, NE. The provider is definition to come. SUPERIOR STREET FAMILY PHYSICIANS NPI is 1255400206. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Fallbrook Family Health Center.

The provider's business location address is:

755 FALLBROOK BLVD
SUITE 100
LINCOLN, NE
ZIP 68521-056
Phone: (402) 441-3575
Fax: (402) 438-2107

The provider's authorized official is Steven J. Saathoff .
The authorized official title is Member/physician and has the following contact phone number (402) 441-3575.

The enumeration date for this NPI number is 11/6/2006 and was last updated on 8/17/2018.


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
1207QA0505XFamily MedicineAdult Medicine19203NEBRASKAYes

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
1=========13MEDICAIDNEBRASKA
2=========13MEDICAIDNEBRASKA

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: 11/14/2023

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