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

Q: What is the provider's specialty?

The provider's specialty is Clinic/Center with taxonomy code 261QR1300X and a focus in Rural Health.

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About Brodstone Memorial Hospital NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRODSTONE MEMORIAL HOSPITAL (NPI 1073590626), doing business as Brodstone Family Medical Center - Superior, is a healthcare organization registered as a rural health in Superior, Nebraska and active in the NPI registry since December 2005. The organization holds an CLIA Accreditation certificate valid through May 17, 2028 and lists Treg Vyzourek, Ceo, as its authorized official.

NPPES Registry Identity

NPI1073590626

Entity TypeOrganization

Primary Taxonomy261QR1300X

Legal Business NameBRODSTONE MEMORIAL HOSPITAL

Location Address525 E 11TH STSuperior, NE 68978-1101

Mailing AddressPo Box 407Superior, NE 68978-0407 · (402) 879-4781 · Fax (402) 879-3365

Phone(402) 879-4781

Fax(402) 879-3365

Organization SubpartYes

Authorized OfficialTreg VyzourekCeo · (402) 879-3281

Enumeration DateDecember 26, 2005

Last NPPES UpdateFebruary 12, 20252 updates tracked since enumeration

NPPES CertifiedFebruary 12, 2025

✔ NPI 1073590626 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 11

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities

Taxonomy Code261QR1300X

Also ListedFamily MedicineTaxonomy 207Q00000X

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedInternal Medicine · Endocrinology, Diabetes & MetabolismTaxonomy 207RE0101X

Also ListedNeurological SurgeryTaxonomy 207T00000X

Also ListedPsychiatry & Neurology · Neurocritical CareTaxonomy 2084A2900X

Also ListedPsychiatry & Neurology · NeurologyTaxonomy 2084N0400X

Also ListedPsychiatry & Neurology · Vascular NeurologyTaxonomy 2084V0102X

Also ListedHospitalistTaxonomy 208M00000X

Also ListedPhysician AssistantTaxonomy 363A00000X

Also ListedNurse PractitionerTaxonomy 363L00000X

525 E 11TH ST, Superior, NE 68978

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Other Names 1

Doing Business AsBrodstone Family Medical Center - Superior

Other Identifiers 1

Medicaid10025177900NE

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 28D0679416

Brodstone Memorial Hospital · Superior, NE

Active · expires May 17, 2028

CLIA Number28D0679416

Laboratory TypeHospital

Certificate Effective DateMay 18, 2026

Certificate Expiration DateMay 17, 2028

Laboratory DirectorDr. Darrell R. Lester

Laboratory Phone(402) 879-3281

Laboratory LocationBrodstone Memorial Hospital520 East 10th Street, Superior, NE 68978

CLIA data matches this NPI record on: Name Phone

This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TERESA B FRAHM NP

Nurse Practitioner