Healthcare Provider Details

I. General information

NPI: 1629157789
Provider Name (Legal Business Name): BRYAN MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 S 48TH ST
LINCOLN NE
68506-1283
US

IV. Provider business mailing address

P.O. BOX 6168
LINCOLN NE
68506-0168
US

V. Phone/Fax

Practice location:
  • Phone: 402-489-0200
  • Fax: 402-481-4755
Mailing address:
  • Phone: 402-483-8590
  • Fax: 402-483-8599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN T WOODRICH
Title or Position: INTERIM PRESIDENT & CEO
Credential:
Phone: 402-481-3548