FAIRBURY CLINIC P.C. NPI 1619948551

NPI Information

  • NPI: 1619948551
  • Provider Name: FAIRBURY CLINIC, P.C.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 825 22ND ST
    FAIRBURY, NE
    ZIP 68352
  • Phone: (402) 729-3361

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NPI Details

FAIRBURY CLINIC, P.C. is a family medicine in Fairbury, NE. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. FAIRBURY CLINIC, P.C. NPI is 1619948551. The provider is registered as an organization entity type.

The provider's business location address is:

825 22ND ST
FAIRBURY, NE
ZIP 68352-299
Phone: (402) 729-3361
Fax: (402) 729-4010

The provider's authorized official is Jacki Moellenberndt .
The authorized official title is Office Manager and has the following contact phone number (402) 729-3361.

The enumeration date for this NPI number is 1/30/2006 and was last updated on 10/12/2010.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR1300XClinic/CenterRural HealthNo
2207Q00000XFamily 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1100300280BMEDICAIDKANSAS
2283826MEDICARE OSCAR/CERTIFICATIONNEBRASKA
3CO4197MEDICARE OSCAR/CERTIFICATIONNEBRASKA
4=========21MEDICAIDNEBRASKA
5=========12MEDICAIDNEBRASKA
6096742MEDICARE OSCAR/CERTIFICATIONNEBRASKA
7100300280AMEDICAIDKANSAS

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: 11/21/2025

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