JENNIE M. MELHAM MEMORIAL MEDICAL CENTER-LTC
NPI 1093880072
Nursing Facility/Intermediate Care Facility in Broken Bow, NE

NPI Status: Active since November 22, 2006

Contact Information

145 MEMORIAL DR
BROKEN BOW, NE
ZIP 68822
Phone: (308) 872-2625
Fax: (308) 872-6116

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About JENNIE M. MELHAM MEMORIAL MEDICAL CENTER-LTC

This page provides the complete NPI Profile along with additional information for Jennie M. Melham Memorial Medical Center-ltc, a provider established in Broken Bow, Nebraska operating as a Nursing Facility/intermediate Care Facility. The healthcare provider is registered in the NPI registry with number 1093880072 assigned on November 2006. The practitioner's primary taxonomy code is 313M00000X with license number LTCH004 (NE). The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's other name is Jennie M. Melham Memorial Medical Center-ltc. The authorized official of this NPI record is Mr. Timothy L Schuckman (Vice President-cfo)

NPI
1093880072
Provider Legal Name
JENNIE M MELHAM MEMORIAL MEDICAL CENTER
Other Organization Name
JENNIE M. MELHAM MEMORIAL MEDICAL CENTER-LTC
Other Name Type
Other Name (5)
Entity Type
Organization
Location Address
145 MEMORIAL DR BROKEN BOW, NE 68822
Location Phone
(308) 872-2625
Location Fax
(308) 872-6116
Mailing Address
PO BOX 250 BROKEN BOW, NE 68822
Mailing Phone
(308) 872-2625
Mailing Fax
(308) 872-6116
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-22-2006
Last Update Date
01-10-2020
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nursing Facility/Intermediate Care Facility

Taxonomy Code
313M00000X
Type
Nursing & Custodial Care Facilities
License No.
LTCH004
License State
NE
Taxonomy Description
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. TIMOTHY L SCHUCKMAN

Authorized Official Title
VICE PRESIDENT-CFO
Authorized Official Phone
(307) 872-2625

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1093880072
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
201831680014
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 1 + 8 + 3 + 1 + 6 + 8 + 0 + 0 + 1 + 4 + 24 = 58
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 58 = 22

The NPI number 1093880072 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 15 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1528098407 JULIE A LINDSTROM D.O.
Individual
Family Medicine145 MEMORIAL DR
BROKEN BOW, NE 68822
(308) 872-2486
1891897997DR. DAVID A MINNICK MD
Individual
Family Medicine145 MEMORIAL DR
BROKEN BOW, NE 68822
(308) 872-2486
1366544033DR. ROBERT R KAHNK MD
Individual
Family Medicine145 MEMORIAL DR
BROKEN BOW, NE 68822
(308) 872-2486
1609937598DR. LOREN HENNING JACOBSEN MD
Individual
Family Medicine145 MEMORIAL DR
BROKEN BOW, NE 68822
(308) 872-2486
1942400585 MELISSA ANN KULHANEK PHARM.D.
Individual
Pharmacist145 MEMORIAL DR
BROKEN BOW, NE 68822
(308) 872-2625
1811311921 JACOB D KARMAZIN PA-C
Individual
Physician Assistant145 MEMORIAL DR
BROKEN BOW, NE 68822
(308) 872-2486
1033657820 LACI KAI SCOTT NP-C
Individual
Nurse Practitioner (Family)145 MEMORIAL DR
BROKEN BOW, NE 68822
(308) 872-2486
1861959017MR. JUSTIN BOUTWELL PA
Individual
Physician Assistant (Medical)145 MEMORIAL DR
BROKEN BOW, NE 68822
(308) 872-2486
1265507677JENNIE M MELHAM MEMORIAL MEDICAL CENTER
Organization
Durable Medical Equipment & Medical Supplies145 MEMORIAL DR
BROKEN BOW, NE 68822
(308) 872-2625
1245305655JENNIE M MELHAM MEMORIAL MEDICAL CENTER
Organization
Hospice Care, Community Based145 MEMORIAL DR
BROKEN BOW, NE 68822
(308) 872-2625
1386271419 VALERIE HARRIS LCSW
Individual
Counselor (Mental Health)145 MEMORIAL DR
BROKEN BOW, NE 68822
(308) 872-4020
1336214394JENNIE M MELHAM MEMORIAL MEDICAL CENTER
Organization
Home Health145 MEMORIAL DR
BROKEN BOW, NE 68822
(308) 872-2625
1366659773JENNIE M MELHAM MEMORIAL MEDICAL CENTER INC
Organization
Nurse Anesthetist, Certified Registered145 MEMORIAL DR
BROKEN BOW, NE 68822
(308) 872-4100
1538232244JENNIE M MELHAM MEMORIAL MEDICAL CENTER INC
Organization
General Acute Care Hospital (Critical Access)145 MEMORIAL DR
BROKEN BOW, NE 68822
(308) 872-4100
1982779641JENNIE M MELHAM MEMORIAL MEDICAL CENTER INC
Organization
General Acute Care Hospital (Critical Access)145 MEMORIAL DR
BROKEN BOW, NE 68822
(308) 872-4100

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1093880072, enumerated in the NPI registry as an "organization" on November 22, 2006

The provider is located at 145 Memorial Dr Broken Bow, Ne 68822 and the phone number is (308) 872-2625

This medical organization specializes in Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X

This NPI record was last updated on November 22, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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