FULLERTON MEDICAL CLINIC
NPI 1124559901
Clinic/Center - Rural Health in Fullerton, NE
NPI Status: Active since March 23, 2017
Contact Information
901 BROADWAY ST
FULLERTON, NE
ZIP 68638
Phone: (308) 536-2458
- Organization
- Clinic/Center
- Rural Health
- Accepts Insurance
- CLIA Number: 28D0886128
- CLIA Cert. Type: Rural Health Clinic
- CLIA Exp. Date: 04-30-2028
About FULLERTON MEDICAL CLINIC
This page provides the complete NPI Profile along with additional information for Fullerton Medical Clinic, a primary care provider established in Fullerton, Nebraska operating as a Clinic/center, focusing in rural health . The healthcare provider is registered in the NPI registry with number 1124559901 assigned on March 2017. The practitioner's primary taxonomy code is 261QR1300X. The provider is registered as an organization and their NPI record was last updated 2 years ago. Fullerton Medical Clinic operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Fullerton Medical Clinic. The authorized official of this NPI record is Jodi S Mohr (Ceo)
- NPI
- 1124559901
- Provider Legal Name
- MERRICK MEDICAL CENTER
- Other Organization Name
- FULLERTON MEDICAL CLINIC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 901 BROADWAY ST FULLERTON, NE 68638
- Location Phone
- (308) 536-2458
- Mailing Address
- PO BOX 860874 MINNEAPOLIS, MN 55486
- Mailing Phone
- (308) 946-3015
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 03-23-2017
- Last Update Date
- 07-24-2024
- Code Navigator
A primary care provider (PCP) like Fullerton Medical Clinic 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) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | |
| 2 | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
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 Premier Select BlueChoice w/ Adult Vision - EPO
- HeartlandBlue Bronze HSA 6500 NEtwork Blue - EPO
- HeartlandBlue Bronze HSA 6500 NEtwork Blue PPO - PPO
- HeartlandBlue Bronze HSA 6500 Premier Select BlueChoice - EPO
- HeartlandBlue Bronze Standard 7500 NEtwork Blue - EPO
- HeartlandBlue Bronze Standard 7500 NEtwork Blue PPO - PPO
- HeartlandBlue Bronze Standard 7500 Premier Select BlueChoice - EPO
- HeartlandBlue Gold $0 PCP Visit 1500 NEtwork Blue - EPO
- Elevate by Medica Bronze $0 Copay PCP Visits - EPO
- Elevate by Medica Bronze Premier - EPO
- Elevate by Medica Bronze Share - EPO
- Elevate by Medica Expanded Bronze Standard - EPO
- Elevate by Medica Gold $0 Copay PCP Visits - EPO
- Elevate by Medica Gold Share - EPO
- Elevate by Medica Gold Standard - EPO
- Elevate by Medica Silver $0 Copay PCP Visits - EPO
- Elevate by Medica Silver Share - EPO
- Elevate by Medica Silver Standard - EPO
- Bronze Classic - EPO
- Bronze Classic | with Bryan Health - EPO
- Bronze Classic Standard - EPO
- Bronze Classic Standard | with Bryan Health - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Bronze Elite + PCP Saver Plus | with Bryan Health - EPO
- Bronze Simple Diabetes - EPO
- Bronze Simple Diabetes | with Bryan Health - EPO
- Gold Classic Standard - EPO
- Gold Classic Standard | with Bryan Health - 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 Standard (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
- UHC Gold Standard (No Referrals) - EPO
- UHC Gold Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - EPO
- UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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
- 28D0886128
- Facility Type
- Rural Health Clinic
- Certificate Effective Date
- May 01, 2026
- Certificate Expiration Date
- April 30, 2028
- Laboratory Director
- DR. BLAKE A. COVER
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Fullerton Medical Clinic 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 1124559901, we treat the final digit (1) 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 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).
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 59 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1124559901, enumerated as an "organization" on March 23, 2017.
The provider is located at 901 BROADWAY ST FULLERTON, NE 68638 and the phone number is (308) 536-2458.
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.
