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BELLEVUE PRIMARY HEALTHCARE PC
NPI 1497091888
Family Medicine in Bellevue, NE

Active since December 12, 2012CLIA 28D2054237 · Waiver
12717 S 28TH AVE, BELLEVUE, NE 68123(402) 525-6976 Get Directions Write a Review

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

About Bellevue Primary Healthcare Pc NPPES

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

BELLEVUE PRIMARY HEALTHCARE PC (NPI 1497091888) is a healthcare organization registered as a family medicine in Bellevue, Nebraska and active in the NPI registry since December 2012. The organization holds a CLIA Waiver certificate valid through February 14, 2027 and lists Kelli Rae Pavlish, Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1497091888
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBELLEVUE PRIMARY HEALTHCARE PC
Location Address12717 S 28TH AVEBellevue, NE 68123-3232
Mailing Address703 Canyon RdBellevue, NE 68005-2735 · (402) 525-6976
Phone(402) 525-6976
Organization SubpartNo
Authorized OfficialKelli Rae PavlishNurse Practitioner · (402) 525-6976
Enumeration DateDecember 12, 2012
Last NPPES UpdateApril 24, 2024
NPPES CertifiedApril 24, 2024
✔ NPI 1497091888 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X · License 111265 (NE)
12717 S 28TH AVE, Bellevue, NE 68123
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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 Waiver 28D2054237

Bellevue Primary Healthcare PC · Bellevue, NE
Active · expires Feb 14, 2027
CLIA Number28D2054237
Laboratory TypePhysician Office
Certificate Effective DateFebruary 15, 2025
Certificate Expiration DateFebruary 14, 2027
Laboratory DirectorMs. Kelli R. Pavlish
Laboratory Phone(402) 292-6006
Laboratory LocationBellevue Primary Healthcare PC1320 Galvin Rd S, Bellevue, NE 68005
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

ROY W.HOLEYFIELD JR. M.D. P.C.
Internal Medicine
12717 S 28TH AVE
BELLEVUE, NE 68123
Sarpy County (402) 991-7071
HAMILTON COUNSELING
Substance Abuse Rehabilitation Facility
12717 S 28TH AVE
BELLEVUE, NE 68123
Sarpy County (402) 639-0435
VALERIE LYNN HEIGHT LCSW, LMHP
Social Worker (Clinical)
12717 S 28TH AVE
BELLEVUE, NE 68123
Sarpy County (402) 292-6006
MR. DOUGLAS R. PENINGTON NP
Nurse Practitioner
12717 S 28TH AVE
BELLEVUE, NE 68123
Sarpy County (402) 292-6006
MR. MICHAEL JAY COOPERMAN PT
Physical Therapist
12717 S 28TH AVE
BELLEVUE, NE 68123
Sarpy County (402) 871-4089

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 Bellevue Primary Healthcare PC's NPI number?

The NPI number for Bellevue Primary Healthcare PC is 1497091888. It was assigned to this organization in the NPPES registry on December 12, 2012.

Where is Bellevue Primary Healthcare PC located?

Bellevue Primary Healthcare PC is located at 12717 S 28th Ave, Bellevue, NE 68123. The listed phone number is (402) 525-6976.

What is Bellevue Primary Healthcare PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Bellevue Primary Healthcare PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 28D2054237) is associated with this NPI, valid through February 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Bellevue Primary Healthcare PC 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 1 other insurer list Bellevue Primary Healthcare PC 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 Bellevue Primary Healthcare PC was last updated on April 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.