JENNIE M. MELHAM MEMORIAL MEDICAL CENTER-LTC
NPI 1093880072
Nursing Facility/Intermediate Care Facility in Broken Bow, NE
NPI Status: Active since November 22, 2006
Contact Information
145 MEMORIAL DR
BROKEN BOW, NE
ZIP 68822
Phone: (308) 872-2625
Fax: (308) 872-6116
- Organization
- Nursing Facility/Intermediate Care Facil...
- CLIA Number: 28D0455865
- CLIA Cert. Type: Hospital
- CLIA Exp. Date: 05-03-2027
About JENNIE M. MELHAM MEMORIAL MEDICAL CENTER-LTC
This page provides the complete NPI Profile along with additional information for Jennie M. Melham Memorial Medical Center-ltc, a provider established in Broken Bow, Nebraska operating as a Nursing Facility/intermediate Care Facility. The healthcare provider is registered in the NPI registry with number 1093880072 assigned on November 2006. The practitioner's primary taxonomy code is 313M00000X with license number LTCH004 (NE). The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's other name is Jennie M. Melham Memorial Medical Center-ltc. The authorized official of this NPI record is Mr. Timothy L Schuckman (Vice President-cfo)
- NPI
- 1093880072
- Provider Legal Name
- JENNIE M MELHAM MEMORIAL MEDICAL CENTER
- Other Organization Name
- JENNIE M. MELHAM MEMORIAL MEDICAL CENTER-LTC
- Other Name Type
- Other Name (5)
- Entity Type
- Organization
- Location Address
- 145 MEMORIAL DR BROKEN BOW, NE 68822
- Location Phone
- (308) 872-2625
- Location Fax
- (308) 872-6116
- Mailing Address
- PO BOX 250 BROKEN BOW, NE 68822
- Mailing Phone
- (308) 872-2625
- Mailing Fax
- (308) 872-6116
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-22-2006
- Last Update Date
- 01-10-2020
- Code Navigator
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
Nursing Facility/Intermediate Care Facility
- Taxonomy Code
- 313M00000X
- Type
- Nursing & Custodial Care Facilities
- License No.
- LTCH004
- License State
- NE
- Taxonomy Description
- An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
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
- 28D0455865
- Facility Type
- Hospital
- Certificate Effective Date
- May 04, 2025
- Certificate Expiration Date
- May 03, 2027
- Laboratory Director
- DR. BYRON L. BARKSDALE
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Jennie M. Melham Memorial Medical Center-ltc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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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 1093880072, we treat the final digit (2) 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 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 58 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 14 providers are registered at the same or a nearby location.
BROKEN BOW, NE 68822
BROKEN BOW, NE 68822
BROKEN BOW, NE 68822
BROKEN BOW, NE 68822
BROKEN BOW, NE 68822
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1093880072, enumerated as an "organization" on November 22, 2006.
The provider is located at 145 MEMORIAL DR BROKEN BOW, NE 68822 and the phone number is (308) 872-2625.
Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.
