Provider Demographics
NPI: | 1306910534 |
---|---|
Name: | REGIONAL WEST PHYSICIANS CLINIC |
Entity type: | Organization |
Organization Name: | REGIONAL WEST PHYSICIANS CLINIC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | NED |
Authorized Official - Middle Name: | P |
Authorized Official - Last Name: | RESCH |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 308-635-3711 |
Mailing Address - Street 1: | PO BOX 1248 |
Mailing Address - Street 2: | |
Mailing Address - City: | SCOTTSBLUFF |
Mailing Address - State: | NE |
Mailing Address - Zip Code: | 69363-1248 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 308-630-2930 |
Mailing Address - Fax: | 308-630-2939 |
Practice Address - Street 1: | 3911 AVENUE B STE 1100 |
Practice Address - Street 2: | |
Practice Address - City: | SCOTTSBLUFF |
Practice Address - State: | NE |
Practice Address - Zip Code: | 69361-4617 |
Practice Address - Country: | US |
Practice Address - Phone: | 308-630-2100 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-11-20 |
Last Update Date: | 2025-06-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical | Group - Multi-Specialty |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207T00000X | Allopathic & Osteopathic Physicians | Neurological Surgery | Group - Multi-Specialty | |
No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
No | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
No | 208800000X | Allopathic & Osteopathic Physicians | Urology | Group - Multi-Specialty | |
No | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | Group - Multi-Specialty | |
No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NE | =========13 | Medicaid | |
NE | CE7423 MEDICARE RR | Medicare PIN | |
NE | 098637 | Medicare PIN | |
WY | W22133 | Medicare PIN | |
WY | CC9608 MEDICARE RR | Medicare PIN |