FULLERTON MEDICAL CLINIC
NPI 1124559901
Clinic/Center - Rural Health in Fullerton, NE
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
Specialties & Licenses 3
Other Names 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Fullerton Medical Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
11Medicare enrollment records show 11 clinicians reassign Medicare billing to Fullerton Medical Clinic, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians by Medicare Specialty 8
Clinicians, nearest first (11)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, NEFrequently 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.
Is Merrick Medical Center enrolled in Medicare?
Yes. Merrick Medical Center is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Merrick Medical Center?
According to the CMS Revalidation Reassignment List (October 2026 release), 11 clinicians in 8 Medicare specialties reassign their Medicare billing to Merrick Medical Center. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Family Practice (3), Nurse Practitioner (2) and Emergency Medicine (1). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Sunflower Health Plan, Blue Cross and Blue Shield of Nebraska and Oscar Insurance Company and 1 other insurer 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.
# Fullerton Medical Clinic · NPI 1124559901
Rural Health organization in Fullerton, Nebraska. Organization record, active in the CMS NPPES registry since March 23, 2017.
## Identity
- **NPI:** 1124559901 (Entity type: Organization)
- **Enumerated:** March 23, 2017
- **Primary specialty:** Clinic/Center - Rural Health · taxonomy 261QR1300X
- **Legal business name:** Merrick Medical Center
- **Organization subpart:** Yes (part of Merrick Medical Center)
- **Authorized official:** Jodi Mohr, CEO
## Practice location
- **Address:** 901 BROADWAY ST, Fullerton, NE 68638-3151
- **Phone:** (308) 536-2458
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 11 clinicians in 8 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (3), Nurse Practitioner (2), Emergency Medicine (1) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 24, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1124559901) · Data from the CMS NPPES public registry.