BRODSTONE MEMORIAL HOSPITAL
NPI 1073590626
Clinic/Center - Rural Health in Superior, NE

NPI Status: Active since December 26, 2005

Contact Information

525 E 11TH ST
SUPERIOR, NE
ZIP 68978
Phone: (402) 879-4781
Fax: (402) 879-3365

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  • Organization
  • Clinic/Center
  • Rural Health
  • Accepts Insurance
  • CLIA Number: 28D1027384
  • CLIA Cert. Type: Rural Health Clinic
  • CLIA Exp. Date: 06-28-2026

About BRODSTONE MEMORIAL HOSPITAL

This page provides the complete NPI Profile along with additional information for Brodstone Memorial Hospital, a primary care provider established in Superior, Nebraska operating as a Clinic/center, focusing in rural health . The healthcare provider is registered in the NPI registry with number 1073590626 assigned on December 2005. The practitioner's primary taxonomy code is 261QR1300X. The provider is registered as an organization and their NPI record was last updated one year ago. Brodstone Memorial Hospital operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's . The authorized official of this NPI record is Treg Vyzourek (Ceo)

NPI
1073590626
Provider Legal Name
BRODSTONE MEMORIAL HOSPITAL
Other Organization Name
Other Name Type
(6)
Entity Type
Organization
Location Address
525 E 11TH ST SUPERIOR, NE 68978
Location Phone
(402) 879-4781
Location Fax
(402) 879-3365
Mailing Address
PO BOX 407 SUPERIOR, NE 68978
Mailing Phone
(402) 879-4781
Mailing Fax
(402) 879-3365
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
12-26-2005
Last Update Date
02-12-2025
Code Navigator

A primary care provider (PCP) like Brodstone Memorial Hospital sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Rural Health

Taxonomy Code
261QR1300X
Type
Ambulatory Health Care Facilities

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207Q00000XAllopathic & Osteopathic Physicians

Family Medicine

 
2207R00000XAllopathic & Osteopathic Physicians

Internal Medicine

 
3207RE0101XAllopathic & Osteopathic Physicians

Internal Medicine
Endocrinology, Diabetes & Metabolism

 
4207T00000XAllopathic & Osteopathic Physicians

Neurological Surgery

 
52084A2900XAllopathic & Osteopathic Physicians

Psychiatry & Neurology
Neurocritical Care

 
62084N0400XAllopathic & Osteopathic Physicians

Psychiatry & Neurology
Neurology

 
72084V0102XAllopathic & Osteopathic Physicians

Psychiatry & Neurology
Vascular Neurology

 
8208M00000XAllopathic & Osteopathic Physicians

Hospitalist

 
9363A00000XPhysician Assistants & Advanced Practice Nursing Providers

Physician Assistant

 
10363L00000XPhysician Assistants & Advanced Practice Nursing Providers

Nurse Practitioner

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Choice Bronze HSA - EPO
  • Choice Bronze HSA + Vision + Adult Dental - EPO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - EPO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • HeartlandBlue Bronze 0% Coinsurance after Deductible NEtwork Blue - EPO
  • HeartlandBlue Bronze 0% Coinsurance after Deductible NEtwork Blue PPO - PPO
  • HeartlandBlue Bronze 6000 Blueprint Health w/ Adult Vision - EPO
  • HeartlandBlue Bronze HSA 6500 Blueprint Health - EPO
  • HeartlandBlue Bronze HSA 6500 NEtwork Blue - EPO
  • HeartlandBlue Bronze HSA 6500 NEtwork Blue PPO - PPO
  • HeartlandBlue Bronze Standard 7500 Blueprint Health - EPO
  • HeartlandBlue Bronze Standard 7500 NEtwork Blue - EPO
  • HeartlandBlue Bronze Standard 7500 NEtwork Blue PPO - PPO
  • HeartlandBlue Gold $0 PCP Visit 1500 Blueprint Health - EPO
  • Medica Insure Bronze $0 Copay PCP Visits - EPO
  • Medica Insure Bronze Premier - EPO
  • Medica Insure Bronze Share - EPO
  • Medica Insure Expanded Bronze Standard - EPO
  • Medica Insure Gold $0 Copay PCP Visits - EPO
  • Medica Insure Gold Share - EPO
  • Medica Insure Gold Standard - EPO
  • Medica Insure Silver $0 Copay PCP Visits - EPO
  • Medica Insure Silver Share - EPO
  • Medica Insure Silver Standard - EPO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Essential (No Referrals) - EPO
  • UHC Bronze Standard (No Referrals) - EPO
  • UHC Bronze Standard+ (Dental + Vision, No Referrals) - EPO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
  • UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

TREG VYZOUREK

Authorized Official Title
CEO
Authorized Official Phone
(402) 879-3281

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
10025177900MEDICAID (05)NE 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
28D1027384
Facility Type
Rural Health Clinic
Certificate Effective Date
June 29, 2024
Certificate Expiration Date
June 28, 2026
Laboratory Director
DR. TIMOTHY D. BLECHA
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Brodstone Memorial Hospital to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1073590626, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
3
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
9
Unchanged
Pos 7
0
Doubled → 0
Pos 8
6
Unchanged
Pos 9
2
Doubled → 4
Check
6
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 5 → 10 → 1 0 → 0 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 4 + 3 + 1 + 0 + 9 + 0 + 6 + 4 + 24 = 54

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 54 is 60. The difference is the calculated check digit.

60 - 54 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1073590626.

Other Providers at the Same Location


The following 7 providers are registered at the same or a nearby location.

Nurse Practitioner
525 E 11TH ST
SUPERIOR, NE 68978
Family Medicine
525 E 11TH ST
SUPERIOR, NE 68978
Family Medicine
525 E 11TH ST
SUPERIOR, NE 68978
Family Medicine
525 E 11TH ST
SUPERIOR, NE 68978
Physician Assistant
525 E 11TH ST
SUPERIOR, NE 68978
Physician Assistant
525 E 11TH ST
SUPERIOR, NE 68978
Nurse Practitioner (Family)
525 E 11TH ST
SUPERIOR, NE 68978

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1073590626, enumerated as an "organization" on December 26, 2005.

The provider is located at 525 E 11TH ST SUPERIOR, NE 68978 and the phone number is (402) 879-4781.

Clinic/Center with taxonomy code 261QR1300X and a focus in Rural Health.

The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter from. Please consult your insurance carrier or call the provider to verify.