# GREAT PLAINS N UROLOGY PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770609232
- **Authorized official:** RICHARD SCHMIDT (MD)
- **Authorized official phone:** (308) 414-1968

## Contact information

- **Practice address:** 600 W 12TH ST, IMPERIAL, NE 69033-3130
- **Practice address phone:** (308) 414-1968
- **Practice address fax:** (308) 534-3404
- **Mailing address:** PO BOX 1542, RAPID CITY, SD 57709-1542
- **Mailing address phone:** (308) 414-1968
- **Mailing address fax:** (308) 534-3404

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 22506 | NE | Yes |

## Other

- **Enumeration date:** 03/22/2007
- **Last updated:** 04/01/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 099638002 | MEDICARE | — |
| 05 | — | 100250070-00 | — | NE |
| 05 | — | 100263002-00 | — | NE |