Healthcare Provider Details
I. General information
NPI: 1053488395
Provider Name (Legal Business Name): UROLOGY CENTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/30/2006
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2301 EASTERN AVE
RED OAK IA
51566-1305
US
IV. Provider business mailing address
105 S 90TH ST
OMAHA NE
68114-3963
US
V. Phone/Fax
- Phone: 712-623-7000
- Fax:
- Phone: 402-397-9800
- Fax: 402-397-7591
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208800000X |
| Taxonomy | Urology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2088F0040X |
| Taxonomy | Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
REBECCA
J
MCCRERY
Title or Position: PRESIDENT
Credential: MD
Phone: 402-397-7989