Organization
AVERA ST ANTHONYS HOSPITAL
Active
Parent organization
AVERA ST ANTHONYS HOSPITAL
Other names
Avera Medical Group O'Neill
Organization subpart
Yes
Provider details
NPI number
Legal business name
AVERA ST ANTHONYS HOSPITAL
Authorized official
MR. TODD E. CONSBRUCK (CEO)
(402) 336-2611
Entity
Organization
Contact information
Practice address
300 N 2ND ST, SUITE 100, ONEILL, NE 68763-1519
(402) 336-2900
Mailing address
PO BOX 270, ONEILL, NE 68763-0270
(402) 336-5154
(402) 336-5137
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026170000
—
NE
05
—
10026174900
—
NE
Enumeration date
06/15/2011
Last updated
07/06/2021
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