Provider Demographics
NPI:1528076924
Name:STELLING, JONATHAN A (MD)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:A
Last Name:STELLING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8055 O ST
Mailing Address - Street 2:STE 300
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2580
Mailing Address - Country:US
Mailing Address - Phone:402-421-0896
Mailing Address - Fax:402-421-0945
Practice Address - Street 1:4800 HOSPITAL PKWY
Practice Address - Street 2:
Practice Address - City:BEATRICE
Practice Address - State:NE
Practice Address - Zip Code:68310-6906
Practice Address - Country:US
Practice Address - Phone:402-223-7303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE18844207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE00817OtherBCBS
IA2998344Medicaid
NE4122OtherMIDLAND'S CHOICE
NE01-06558OtherUHC
NE10025323000Medicaid
SD7717740Medicaid
SD7717740Medicaid
NE279797Medicare PIN
E91860Medicare UPIN