Active NPI 1902825904 Individual Practitioner Male Practitioner

Chad Michael Hillyer , PA-C

Dermatology • Elkhorn, NE

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Chad Hillyer, PA-C is a certified Dermatology practicing in Elkhorn, NE. With approximately 26 years of clinical experience since completing medical education in 2000, Chad Hillyer delivers high-quality medical care to the local community at 1408 VETERANS DR.

Chad Hillyer is affiliated with Skin Pc and accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, injection, triamcinolone acetonide, not otherwise specified, 10 mg, established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1408 Veterans Dr
Ste 100

Elkhorn, NE 680226912

Telephone 4029165665

Fax 4029342719

Associated Practice Facility / Clinic

🏢 Skin Pc Facility NPI 1134410764

Medicare Profile & Education

Medical School

Other

Graduation Year

2000

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Elkhorn, NE

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

26 Yrs Matches City Avg

City Avg: 26.0 Yrs

State Avg: 20.7 Yrs

Regional Practice Density

1 Specialists

Practicing in Elkhorn, NE (78 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

62.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Hillyer (26 Years) 26 Yrs

Elkhorn Specialty Average (26.0 Years) 26.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,028	200	$20.00	$5.34
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	524	75	$15.00	$0.99
99213 Established patient office or other outpatient visit, typically 15 minutes	461	384	$160.00	$72.70
17000 Destruction of skin growth	295	252	$150.00	$47.46
17004 Destruction of precancer skin growth, 15 or more growths	183	150	$320.00	$132.63
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	168	168	$225.00	$88.54
17110 Destruction of up to 14 skin growths	148	135	$230.00	$85.86
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	85	57	$54.29	$11.47
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	59	51	$130.00	$45.11
11900 Injection into skin growth, 1-7 growths	38	21	$125.00	$43.13
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	34	27	$408.97	$155.89
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	28	27	$225.00	$102.67
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	26	21	$360.00	$123.97
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	22	18	$334.80	$134.77
11102 Tangential biopsy of single skin lesion	18	18	$205.00	$68.53
10040 Acne surgery	15	13	$225.00	$92.17
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	13	12	$250.00	$88.91
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	11	11	$285.00	$108.06
99202 New patient office or other outpatient visit, typically 20 minutes	11	11	$165.00	$57.79
10060 Simple or single drainage of skin abscess	11	11	$250.00	$96.61

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,434	277	$20.00	$5.34
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	607	97	$15.00	$1.07
99213 Established patient office or other outpatient visit, typically 15 minutes	597	474	$160.00	$71.90
17000 Destruction of skin growth	389	332	$150.00	$48.52
17004 Destruction of precancer skin growth, 15 or more growths	191	163	$320.00	$133.88
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	163	163	$225.00	$88.60
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	127	77	$55.00	$11.31
17110 Destruction of up to 14 skin growths	118	114	$230.00	$86.68
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	40	37	$410.00	$155.58
11900 Injection into skin growth, 1-7 growths	39	25	$125.00	$40.03
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	33	32	$225.00	$102.06
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	32	29	$130.00	$44.92
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	22	18	$337.73	$122.65
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	22	18	$360.00	$130.18
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	19	13	$375.00	$122.54
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	13	13	$285.00	$88.40
11102 Tangential biopsy of single skin lesion	12	11	$205.00	$70.63
99202 New patient office or other outpatient visit, typically 20 minutes	11	11	$162.27	$57.43
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	11	11	$385.00	$153.72

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,732	329	$20.00	$5.46
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	744	129	$15.00	$1.15
99213 Established patient office or other outpatient visit, typically 15 minutes	686	519	$160.00	$72.67
17000 Destruction of skin growth	470	391	$150.00	$48.36
17004 Destruction of precancer skin growth, 15 or more growths	201	170	$320.00	$135.22
17110 Destruction of up to 14 skin growths	192	167	$230.00	$87.70
17003 Destruction of precancer skin growth, 2-14 growths	155	25	$20.00	$1.71
99202 New patient office or other outpatient visit, typically 20 minutes	154	154	$165.00	$58.10
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	150	85	$55.00	$11.51
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	148	148	$224.59	$88.95
11900 Injection into skin growth, 1-7 growths	80	46	$125.00	$39.77
99213 Established patient office or other outpatient visit, typically 15 minutes	60	42	$160.00	$53.76
17000 Destruction of skin growth	44	35	$150.00	$36.98
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	43	34	$411.74	$158.75
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	33	30	$130.00	$45.01
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	26	19	$360.00	$135.42
17004 Destruction of precancer skin growth, 15 or more growths	25	15	$320.00	$77.35
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	24	24	$225.00	$103.06
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	21	12	$375.00	$147.66
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	20	15	$355.00	$121.63
17110 Destruction of up to 14 skin growths	20	18	$230.00	$52.55
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	20	20	$225.00	$66.23
99202 New patient office or other outpatient visit, typically 20 minutes	18	18	$165.00	$39.04
11102 Tangential biopsy of single skin lesion	16	15	$205.00	$79.29
10060 Simple or single drainage of skin abscess	12	12	$250.00	$95.63

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	967	221	$19.71	$5.28
99213 Established patient office or other outpatient visit, typically 15 minutes	448	377	$159.03	$73.47
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	432	79	$14.63	$1.26
17000 Destruction of skin growth	324	273	$149.07	$47.69
17004 Destruction of precancer skin growth, 15 or more growths	158	142	$318.48	$133.41
99202 New patient office or other outpatient visit, typically 20 minutes	137	137	$163.69	$58.24
17110 Destruction of up to 14 skin growths	132	119	$228.07	$88.57
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	87	64	$54.77	$11.44
17003 Destruction of precancer skin growth, 2-14 growths	83	21	$19.40	$1.75
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	58	58	$224.74	$90.14
99213 Established patient office or other outpatient visit, typically 15 minutes	48	43	$158.44	$54.66
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	40	39	$122.38	$45.34
17000 Destruction of skin growth	29	24	$150.00	$37.20
17110 Destruction of up to 14 skin growths	21	16	$229.29	$52.82
11900 Injection into skin growth, 1-7 growths	20	17	$123.50	$36.32
17004 Destruction of precancer skin growth, 15 or more growths	20	16	$320.00	$78.63
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	19	18	$407.63	$157.54
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	18	16	$355.00	$140.08
99202 New patient office or other outpatient visit, typically 20 minutes	15	15	$165.00	$39.61
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	14	14	$225.00	$67.15

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	952	202	$15.02	$4.89
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	441	85	$10.05	$1.47
99213 Established patient office or other outpatient visit, typically 15 minutes	423	345	$143.19	$60.47
17000 Destruction of skin growth	295	253	$146.36	$47.41
99202 New patient office or other outpatient visit, typically 20 minutes	127	127	$147.40	$61.04
17004 Destruction of precancer skin growth, 15 or more growths	99	91	$310.96	$127.53
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	90	66	$54.78	$11.51
17110 Destruction of up to 14 skin growths	90	83	$211.33	$86.23
17003 Destruction of precancer skin growth, 2-14 growths	86	20	$15.00	$1.81
99213 Established patient office or other outpatient visit, typically 15 minutes	54	41	$145.00	$41.95
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	38	38	$209.61	$86.63
17000 Destruction of skin growth	31	28	$150.00	$37.26
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	29	20	$388.28	$144.24
11900 Injection into skin growth, 1-7 growths	24	22	$110.00	$39.64
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	21	19	$269.29	$102.05
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	16	14	$340.00	$130.49
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	15	13	$335.00	$132.94
99202 New patient office or other outpatient visit, typically 20 minutes	14	14	$150.00	$41.01
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	11	11	$206.36	$88.34

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,363	268	$15.00	$4.34
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	564	101	$10.00	$1.60
99213 Established patient office or other outpatient visit, typically 15 minutes	516	394	$143.66	$59.08
17000 Destruction of skin growth	414	354	$150.00	$45.29
99202 New patient office or other outpatient visit, typically 20 minutes	226	226	$148.21	$60.51
17004 Destruction of precancer skin growth, 15 or more growths	133	115	$315.00	$119.53
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	119	80	$54.37	$13.29
17003 Destruction of precancer skin growth, 2-14 growths	112	21	$15.00	$1.87
17110 Destruction of up to 14 skin growths	85	81	$213.24	$77.72
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	57	57	$210.00	$84.60
99213 Established patient office or other outpatient visit, typically 15 minutes	51	44	$140.88	$41.26
17000 Destruction of skin growth	39	34	$150.00	$38.19
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	33	30	$270.00	$105.22
99202 New patient office or other outpatient visit, typically 20 minutes	32	32	$145.31	$40.71
11900 Injection into skin growth, 1-7 growths	30	23	$110.00	$39.22
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	30	28	$228.40	$76.62
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	27	24	$214.04	$93.16
11312 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	26	24	$301.54	$122.64
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	23	20	$389.30	$154.73
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	20	16	$337.20	$123.51
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	16	16	$273.19	$110.27
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	16	13	$334.56	$125.84
11102 Tangential biopsy of single skin lesion	16	16	$190.00	$67.96
17110 Destruction of up to 14 skin growths	14	11	$212.86	$50.61
10060 Simple or single drainage of skin abscess	13	13	$223.85	$90.63

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,564	311	$15.00	$4.01
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	635	110	$10.00	$1.80
99213 Established patient office or other outpatient visit, typically 15 minutes	560	440	$130.13	$57.52
17000 Destruction of skin growth	461	392	$150.00	$43.52
99202 New patient office or other outpatient visit, typically 20 minutes	239	239	$135.13	$59.32
17003 Destruction of precancer skin growth, 2-14 growths	135	29	$15.00	$1.85
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	121	87	$50.00	$16.21
17004 Destruction of precancer skin growth, 15 or more growths	105	88	$315.00	$113.12
17110 Destruction of up to 14 skin growths	80	70	$200.19	$80.44
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	56	45	$206.00	$79.90
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	45	39	$202.00	$75.87
11900 Injection into skin growth, 1-7 growths	41	28	$110.00	$39.22
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	40	28	$332.00	$120.16
17000 Destruction of skin growth	40	35	$150.00	$37.44
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	36	30	$243.00	$93.77
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	35	28	$209.00	$88.01
99202 New patient office or other outpatient visit, typically 20 minutes	35	35	$135.00	$40.28
99213 Established patient office or other outpatient visit, typically 15 minutes	34	31	$130.00	$41.10
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	29	28	$85.00	$34.61
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	23	17	$383.00	$153.18
11312 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	23	21	$275.00	$117.59
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	19	19	$190.00	$85.80
10060 Simple or single drainage of skin abscess	15	15	$210.00	$86.22
17271 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	15	15	$307.00	$102.35
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	14	13	$246.00	$105.62

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,251	241	$15.00	$4.31
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	776	117	$10.00	$1.78
99213 Established patient office or other outpatient visit, typically 15 minutes	592	448	$130.00	$57.65
17000 Destruction of skin growth	367	306	$150.00	$45.12
99202 New patient office or other outpatient visit, typically 20 minutes	234	234	$135.00	$58.53
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	133	95	$50.00	$19.86
17003 Destruction of precancer skin growth, 2-14 growths	123	28	$15.00	$1.86
17004 Destruction of precancer skin growth, 15 or more growths	96	88	$315.00	$116.14
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	79	75	$84.43	$34.29
99213 Established patient office or other outpatient visit, typically 15 minutes	45	39	$130.00	$40.87
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	44	33	$204.91	$76.77
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	43	35	$329.77	$114.16
11900 Injection into skin growth, 1-7 growths	41	26	$110.00	$41.89
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	40	37	$200.60	$72.61
17110 Destruction of up to 14 skin growths	37	36	$200.00	$79.38
99202 New patient office or other outpatient visit, typically 20 minutes	33	33	$135.00	$40.31
17000 Destruction of skin growth	32	30	$150.00	$38.65
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	27	23	$241.22	$96.12
11100 Biopsy of single growth of skin and/or tissue	23	23	$199.13	$73.36
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	17	15	$207.94	$78.90
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	17	15	$381.29	$149.50
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	16	15	$457.19	$186.85
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	16	15	$190.00	$85.32
10060 Simple or single drainage of skin abscess	15	14	$207.33	$89.27
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	15	13	$499.67	$189.94
11312 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	15	14	$271.67	$108.51
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	15	11	$393.33	$355.12
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	13	11	$255.38	$104.02

Medical Specialties & State Licenses

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License NE 1041

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Rr Medicare

P01022462 (NE)

Hospital & Practice Group Affiliations

Skin Pc

1408 Veterans Dr, Elkhorn, NE 680226912

Phone: 4029165665

Skin Pc

1408 Veterans Dr, Elkhorn, NE 680226912

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners

Dr. Matthew Perry , DPT

Physical Therapist

NPI 1124383328

Doctor of Physical Therapy

Susan Alberts , PT

Physical Therapist

NPI 1245531565

Physical Therapist

Erin Zogleman

Speech-Language Pathologist

NPI 1770255564

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active July 18, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location July 18, 2016

Registered at 1408 VETERANS DR, STE 100, ELKHORN, NE 680226912 (Tel: 4029165665)

📍

Updated Business Mailing Address July 18, 2016

Registered at 1408 VETERANS DR, STE 100, ELKHORN, NE 680226912 (Tel: 4029165665)

👤

Provider Name / Credentials Updated July 18, 2016

Recorded as CHAD HILLYER, PA-C

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 18, 2016

Dermatology (License #1041 in NE)

🟢

Initial NPI Registration & Enumeration July 19, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews

No patient reviews submitted yet for Chad Hillyer. Be the first to share your experience!

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1902825904

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 19, 2006

Last Update: July 18, 2016

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1408 Veterans Dr, Ste 100

Elkhorn, NE 680226912

Phone: 4029165665

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.