PELLA REGIONAL HEALTH CENTER (NPI# 1053369405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053369405 |
| Entity Type | Organization |
| Organization Name | PELLA REGIONAL HEALTH CENTER |
| Other Organization Name | PELLA MEDICAL CLINIC |
| Practice Address |
405 Monroe St Pella IA 50219-1189 |
| Practice Telephone | 6416283832 |
| Practice Fax Number | 6416288894 |
| Mailing Telephone | 6416283832 |
| Mailing Fax Number | 6416288894 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2014-10-20 |
| Authorized Official Name | ROBERT D KROESE (CEO) |
| Authorized Official Telephone | 6416286604 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 630165H | IA | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 630165H | IA | Allopathic & Osteopathic Physicians |
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
630165H | IA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0147223 | 05 | |
| IA | RAILROAD MEDICARE | CC5750 | 01 |
| IA | CLIA NUMBER | 16D0383077 | 01 |
| Other Name | Type Code |
|---|---|
| Pella Medical Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053924449 | Pella Regional Health Center | Clinic/Center | 404 S Commerce, Prairie City, IA 50228-8560 | 2020-08-26 |
| 1952773921 | Pella Regional Health Center | Clinic/Center | 611 N Hancock St, Ottumwa, IA 52501-4233 | 2015-10-29 |
| 1619030988 | Pella Regional Health Center | Residential Treatment Facility, Physical Disabilities | 408 Jefferson St, Pella, IA 50219-1257 | 2006-12-18 |
| 1447294608 | Pella Regional Health Center | Clinic/Center | 100 East Sherman Street, Monroe, IA 50170 | 2006-06-16 |
| 1104860808 | Pella Regional Health Center | Clinic/Center | 704 3rd St, Sully, IA 50251-1016 | 2006-06-15 |
| 1245712942 | Pella Regional Health Center | Family Medicine | 100 E Jefferson St, Prairie City, IA 50228-7709 | 2018-08-30 |
| 1154709327 | Pella Regional Health Center | Clinical Medical Laboratory | 404 Jefferson St, Pella, IA 50219-1257 | 2015-05-08 |
| 1932599404 | Pella Regional Health Center | Pharmacy | 802 Washington St, Pella, IA 50219-1525 | 2015-02-04 |
| 1851722128 | Pella Regional Health Center | Family Medicine | 1210 E Vermeer Rd, Pella, IA 50219-7660 | 2013-12-11 |
| 1508101221 | Pella Regional Health Center | Clinic/Center | 920 N Quincy Ave, Ottumwa, IA 52501-3866 | 2012-12-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PELLA REGIONAL HEALTH CENTER | 404 Jefferson St, Pella, IA 50219-1257 |
| Street Address |
405 MONROE ST |
| City | PELLA |
| State | IA |
| Zip Code | 50219-1189 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477557411 | Dale Lee Lensing | Obstetrics & Gynecology | 405 Monroe St, Pella, IA 50219-1189 | 2005-06-08 |
| 1932619475 | Pella Regional Health Center Clinic Pharmacy | Pharmacy | 405 Monroe St, Pella, IA 50219 | 2017-10-11 |
| 1952810087 | Jessica Lee Streeter | Nurse Practitioner | 405 Monroe St, Pella, IA 50219-1189 | 2017-09-20 |
| 1740649300 | Tamara Jean Pommer | Physical Therapist | 405 Monroe St, Pella, IA 50219-1189 | 2016-02-11 |
| 1750740361 | Janna Marie Hansen-nolin | Speech-Language Pathologist | 405 Monroe St, Pella, IA 50219-1189 | 2016-02-11 |
| 1487013017 | Tara Dawn Temperly-leidigh | Speech-Language Pathologist | 405 Monroe St, Pella, IA 50219-1189 | 2016-02-10 |
| 1275991804 | Jacklyn Sue Lowe | Speech-Language Pathologist | 405 Monroe St, Pella, IA 50219-1189 | 2016-02-10 |
| 1487012001 | Amy Jean Herdegen | Physical Therapist | 405 Monroe St, Pella, IA 50219-1189 | 2016-02-10 |
| 1225496854 | Sarah Christine Vogel | Occupational Therapist | 405 Monroe St, Pella, IA 50219-1189 | 2016-02-10 |
| 1528434859 | Mindy Baccam Southammavong | Physician Assistant | 405 Monroe St, Pella, IA 50219-1189 | 2015-08-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366967101 | Emily Rachel Dine | Specialist/Technologist | 812 University, Pella, IA 50219 | 2017-08-12 |
| 1588105597 | Brett Boddicker | Student in an Organized Health Care Education/Training Program | 812 University Street, Pella, IA 50219 | 2017-03-10 |
| 1053780098 | Jeremy Richard Dolder | Specialist/Technologist | 812 University St., Pella, IA 50219 | 2015-09-21 |
| 1588921084 | Michael Gary Walsh | Psychiatry & Neurology | 710 W 1st St, Pella, IA 50219 | 2012-04-20 |
| 1063788602 | Multicultural International Counseling Enterprises, Inc. | Psychologist | 311 Franklin Street, Pella, IA 50219 | 2012-03-28 |
| 1568798056 | Megan Lee Nelson | Physical Therapist | 405 Monroe Street, Pella, IA 50219 | 2009-10-19 |
| 1578783247 | Suzanne Vonseggern | Pharmacist | 1610 Vemeer Rd, East Plant 3, Pella, IA 50219 | 2007-04-26 |
| 1669513057 | Heather Renee Pilcher | Physical Therapy Assistant | 308 Se 9th St., Pella, IA 50219 | 2007-02-09 |
| 1164578134 | Walgreen Co. | Pharmacy | 1610 Vermeer Road East, Plant 3 1/2, Pella, IA 50219 | 2007-01-25 |
| 1841373289 | Jeffrey Frank Allen | Dentist | 839 Broadway, Pella, IA 50219 | 2006-10-21 |
| Find all providers in zip 50219 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 1548588171 | Rchp - Ottumwa LLC | Clinic/Center | 1001 Pennsylvania Ave, Central Clinic Bldg., Ottumwa, IA 52501-6427 | 2010-05-06 |
| 1285809095 | Tops II, LLC | Clinic/Center | 2800 Pierce St, Suite 101, Sioux City, IA 51104-3755 | 2008-04-23 |
| 1568509529 | Francis Lauer Youth Services | Clinic/Center | 50 N Eisenhower Ave, Mason City, IA 50401 | 2007-01-31 |
| 1992854863 | Winneshiek Medical Center | Clinic/Center | 901 Montgomery St, Decorah, IA 52101-2325 | 2007-01-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.