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WAVERLY HEALTH CARE URGENT CARE
NPI 1780814475
Family Medicine in Waverly, NE

Active since July 16, 2009CLIA 28D1099228 · Waiver
13220 CALLUM DR, STE 4, WAVERLY, NE 68462(402) 786-5563(402) 423-4201 Get Directions Write a Review

NPPES record last updated: August 30, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 30, 2022, Sep 12, 2019 (2 updates tracked since 2019).

About Waverly Health Care Urgent Care NPPES

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

WAVERLY HEALTH CARE URGENT CARE (NPI 1780814475) is a healthcare organization registered as a family medicine in Waverly, Nebraska and active in the NPI registry since July 2009. The organization holds a CLIA Waiver certificate valid through June 6, 2028 and lists Matthew M Glenn, Physician, as its authorized official.

NPPES Registry Identity

NPI1780814475
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePINE LAKE HEALTH LLC
Location Address13220 CALLUM DR, STE 4Waverly, NE 68462-2561
Mailing Address2611 S 70th StLincoln, NE 68506-2960 · (402) 423-4200 · Fax (402) 423-4201
Phone(402) 786-5563
Fax(402) 423-4201
Organization SubpartYesParent: Pine Lake Health, Llc
Authorized OfficialMatthew M GlennPhysician · (402) 423-4200
Enumeration DateJuly 16, 2009
Last NPPES UpdateAugust 30, 20222 updates tracked since enumeration
NPPES CertifiedAugust 30, 2022
✔ NPI 1780814475 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ 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 ListedPhysician AssistantTaxonomy 363A00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
13220 CALLUM DR, Waverly, NE 68462
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Other Names 1

Doing Business AsWaverly Health Care Urgent Care

Other Identifiers 1

Medicaid10025748100NE

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 28D1099228

Waverly Health Care Urgent Care · Waverly, NE
Active · expires Jun 6, 2028
CLIA Number28D1099228
Laboratory TypePhysician Office
Certificate Effective DateJune 7, 2026
Certificate Expiration DateJune 6, 2028
Laboratory DirectorMegan Skradis
Laboratory Phone(402) 423-4200
Laboratory LocationWaverly Health Care Urgent Care13220 Callum Drive Ste 4, Waverly, NE 68462
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 3

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

RIDER CHIROPRACTIC PC
Chiropractor
13220 CALLUM DR, SUITE 2
WAVERLY, NE 68462
Lancaster County (402) 990-0648
XCEED CHIROPRACTIC, PC
Chiropractor
13220 CALLUM DR, STE 2
WAVERLY, NE 68462
Lancaster County (402) 786-0257
DR. RACHELLE LEE RIDER D.C.
Chiropractor
13220 CALLUM DR, SUITE 2
WAVERLY, NE 68462
Lancaster County (402) 990-0648

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 Pine Lake Health LLC's NPI number?

The NPI number for Pine Lake Health LLC is 1780814475. It was assigned to this organization in the NPPES registry on July 16, 2009. The provider is doing business as Waverly Health Care Urgent Care.

Where is Pine Lake Health LLC located?

Pine Lake Health LLC is located at 13220 Callum Dr Ste 4, Waverly, NE 68462. The listed phone number is (402) 786-5563.

What is Pine Lake Health LLC's specialty?

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

Does Pine Lake Health LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 28D1099228) is associated with this NPI, valid through June 6, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Pine Lake Health LLC accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and Medica and 1 other insurer list Pine Lake Health LLC 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 Pine Lake Health LLC was last updated on August 30, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.