| Callaway Hospital Professional Services | |
|
211 E Kimball St Callaway NE 68825-2597 | |
| (308) 836-2228 | |
| (308) 836-2733 |
| Full Name | Callaway Hospital Professional Services |
|---|---|
| Speciality | Family Medicine |
| Location | 211 E Kimball St, Callaway, Nebraska |
| Authorized Official Name and Position | Brett D Eggleston (CEO) |
| Authorized Official Contact | 3088362228 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Callaway Hospital Professional Services Po Box 100 Callaway NE 68825-0100 Ph: (308) 836-2228 | Callaway Hospital Professional Services 211 E Kimball St Callaway NE 68825-2597 Ph: (308) 836-2228 |
| NPI Number | 1508979899 |
|---|---|
| Provider Enumeration Date | 08/17/2006 |
| Last Update Date | 01/16/2019 |
| Medicare PECOS PAC ID | 0143208983 |
|---|---|
| Medicare Enrollment ID | O20040714000240 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508979899 | NPI | - | NPPES |
| 10025136800 | Medicaid | NE | |
| DC3835 | Other | NE | MEDICARE RAILROAD |
| 04058 | Other | NE | BCBS OF NEBRASKA |
| 10025136700 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| 363AM0700X | Physician Assistant - Medical | () | Secondary |
| Provider Name | Kenneth L Loper |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750399903 PECOS PAC ID: 7113985839 Enrollment ID: I20041228000911 |
| Provider Name | Julie a Brauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437349511 PECOS PAC ID: 6305934282 Enrollment ID: I20071109000269 |
| Provider Name | Kyle S Myers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992142087 PECOS PAC ID: 5597987727 Enrollment ID: I20141104000474 |
| Provider Name | Denise L Poland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871945139 PECOS PAC ID: 6800189614 Enrollment ID: I20160801000484 |
| Provider Name | Tiffany L Svoboda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457732224 PECOS PAC ID: 3870800253 Enrollment ID: I20170630001467 |
| Provider Name | Tessa J Keeney |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1710471537 PECOS PAC ID: 1153679469 Enrollment ID: I20180802002440 |
| Provider Name | Bethany J Collins |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1487330122 PECOS PAC ID: 1153851126 Enrollment ID: I20250205002760 |
Callaway Medical Clinic Bcbs Pcmh Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 213 E Kimball St, Callaway, NE 68825 Phone: 308-836-2294 Fax: 308-836-2451 |
Callaway Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 213 E Kimball St, Callaway, NE 68825 Phone: 308-836-2294 Fax: 308-836-2451 |