FULLERTON MEDICAL CLINIC
NPI 1124559901
Clinic/Center - Rural Health in Fullerton, NE

Active since March 23, 2017CLIA 28D0886128 · Waiver
901 BROADWAY ST, FULLERTON, NE 68638(308) 536-2458 Get Directions Write a Review

NPPES record last updated: July 24, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 24, 2024, Nov 6, 2023, Oct 24, 2023 and 9 more (12 updates tracked since 2017).

About Fullerton Medical Clinic NPPES

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

FULLERTON MEDICAL CLINIC (NPI 1124559901) is a healthcare organization registered as a rural health in Fullerton, Nebraska and active in the NPI registry since March 2017. The organization holds a CLIA Waiver certificate valid through April 30, 2028 and lists Jodi S Mohr, Ceo, as its authorized official.

NPPES Registry Identity

NPI1124559901
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameMERRICK MEDICAL CENTER
Location Address901 BROADWAY STFullerton, NE 68638-3151
Mailing AddressPo Box 860874Minneapolis, MN 55486-0874 · (308) 946-3015 · Fax (308) 946-5914
Organization SubpartYes
Authorized OfficialJodi S MohrCeo · (402) 946-3015
Enumeration DateMarch 23, 2017
Last NPPES UpdateJuly 24, 202412 updates tracked since enumeration
NPPES CertifiedJuly 24, 2024
NPI 1124559901 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedPhysician AssistantTaxonomy 363A00000X
901 BROADWAY ST, Fullerton, NE 68638

Other Names 1

Doing Business AsFullerton Medical Clinic

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

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 Waiver 28D0886128

Fullerton Medical Clinic · Fullerton, NE
Active · expires Apr 30, 2028
CLIA Number28D0886128
Laboratory TypeRural Health Clinic
Certificate Effective DateMay 1, 2026
Certificate Expiration DateApril 30, 2028
Laboratory DirectorDr. Blake A. Cover
Laboratory Phone(308) 536-2458
Laboratory LocationFullerton Medical Clinic901 Broadway Street, Fullerton, NE 68638
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

Clinic/Center (Rural Health)
901 BROADWAY ST
FULLERTON, NE 68638
Family Medicine
901 BROADWAY ST
FULLERTON, NE 68638

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Merrick Medical Center's NPI number?

The NPI number for Merrick Medical Center is 1124559901. It was assigned to this organization in the NPPES registry on March 23, 2017. The provider is doing business as Fullerton Medical Clinic.

Where is Merrick Medical Center located?

Merrick Medical Center is located at 901 Broadway St, Fullerton, NE 68638. The listed phone number is (308) 536-2458.

What is Merrick Medical Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Merrick Medical Center hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 28D0886128) is associated with this NPI, valid through April 30, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Merrick Medical Center accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and Blue Cross and Blue Shield of Nebraska and 3 other insurers list Merrick Medical Center as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Merrick Medical Center was last updated on July 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.