JOHN DEERE MEDICAL GROUP OF WATERLOO, PC (NPI# 1063525277) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063525277 |
| Entity Type | Organization |
| Organization Name | JOHN DEERE MEDICAL GROUP OF WATERLOO, PC |
| Practice Address |
1015 S Hackett Rd Waterloo IA 50701-3500 |
| Practice Telephone | 3192741000 |
| Practice Fax Number | 3192926526 |
| Mailing Telephone | 3192741000 |
| Mailing Fax Number | 3192926526 |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. GREGORY L HOEKSTRA (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 3192741016 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 01585 | IA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 1097592 | 05 |
| Street Address |
1015 S HACKETT RD |
| City | WATERLOO |
| State | IA |
| Zip Code | 50701-3500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598763286 | Brett R Richman | Obstetrics & Gynecology | 1015 S Hackett Rd, Suite 200, Waterloo, IA 50701-3500 | 2005-07-07 |
| 1457801326 | Kelli Deserano | Nurse Practitioner | 1015 S Hackett Rd, Waterloo, IA 50701-3500 | 2016-10-04 |
| 1861745507 | Arun Kumar Muthusamy | Internal Medicine | 1015 S Hackett Rd, Waterloo, IA 50701-3500 | 2012-10-18 |
| 1588919351 | Tracy R Elliott | Nurse Practitioner | 1015 S Hackett Rd, Waterloo, IA 50701-3500 | 2012-07-18 |
| 1053608687 | Suhag Maheshbhai Patel | Internal Medicine | 1015 S Hackett Rd, Waterloo, IA 50701-3500 | 2011-07-04 |
| 1699929182 | Jennifer Smentek Jampoler | Social Worker | 1015 S Hackett Rd, Waterloo, IA 50701-3500 | 2008-11-10 |
| 1619140910 | Srinivas Kalala | Internal Medicine | 1015 S Hackett Rd, Waterloo, IA 50701-3500 | 2008-04-08 |
| 1750570172 | Mohamad Hamdi | Obstetrics & Gynecology | 1015 S Hackett Rd, Suite 200, Waterloo, IA 50701-3500 | 2007-10-22 |
| 1851515688 | Santhi Keeran | Family Medicine | 1015 S Hackett Rd, Waterloo, IA 50701-3500 | 2007-04-12 |
| 1851425276 | Department of Veterans Affairs Outpatient Clinic | Clinic/Center | 1015 S Hackett Rd, Waterloo, IA | 2007-03-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548757586 | Shawna Harvey | Optometrist | 999 Home Plz Ste 100, Waterloo, IA 50701 | 2018-04-16 |
| 1831693290 | Blue Gregory Boyer | Counselor | 3362 University Ave., Waterloo, IA 50701 | 2018-03-21 |
| 1518460666 | Tom Taylor | Specialist | 974 Home Plaza, Waterloo, IA 50701 | 2018-03-15 |
| 1194247551 | Homelink Sanford | Durable Medical Equipment & Medical Supplies | 1111 W San Marnan Drive, Waterloo, IA 50701 | 2017-07-07 |
| 1932471109 | Walgreens | Pharmacy | 111 W Ridgeway Avenue, Waterloo, IA 50701 | 2012-02-03 |
| 1598055188 | Knox Eyecare | Optometrist | 1030 Alabar Ave., Waterloo, IA 50701 | 2011-04-15 |
| 1013222330 | Ashley Lynn Charmichael | Dentist | 220 W. Ridgeway Ave., Suite 201, Waterloo, IA 50701 | 2010-08-11 |
| 1396062311 | Gwendoline Fang | Obstetrics & Gynecology | 1015 S. Hackett Road Suite 200, Department of Ob/gyn, Waterloo, IA 50701 | 2010-04-29 |
| 1013234194 | Ryan Norman Borgwardt | Dentist | 820 Fisher Drive, Waterloo, IA 50701 | 2010-04-28 |
| 1629302310 | Rhonda Kay Herum | Social Worker | 3731 Pheasant Lane #203, Waterloo, IA 50701 | 2009-09-28 |
| Find all providers in zip 50701 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518460666 | Tom Taylor | Specialist | 974 Home Plaza, Waterloo, IA 50701 | 2018-03-15 |
| 1851667141 | Michele Danielle Miller | Specialist | 108 Main Street Shop Ctr, Waterloo, NY 13165-1453 | 2012-03-30 |
| 1982866042 | Gina Lee Haberl | Specialist | 108 Evergreen Ct, Waterloo, IL 62298-1611 | 2008-06-30 |
| 1881656734 | A Step Ahead Therapy Center, Inc. | Specialist | 3606 Kimball Ave, Waterloo, IA 50702-5731 | 2006-04-05 |
| 1679915466 | Amy Diane Putney | Specialist | 315 E San Marnan Dr, Waterloo, IA 50702-5837 | 2013-07-23 |
| 1164632766 | Sadia Ali | Specialist | 2710 Saint Francis Dr, Suite 210, Waterloo, IA 50702-5619 | 2007-05-23 |
| 1144339060 | Health Care Solutions, Plc | Specialist | 3421 W 9th St, Waterloo, IA 50702-5401 | 2006-08-30 |
| 1710091251 | Gregory L Hoekstra | Specialist | 1015 S Hackett Rd, Waterloo, IA 50701-3500 | 2006-08-19 |
| 1386654879 | Bastug Plastic Surgery PC | Specialist | 2710 Saint Francis Dr, Suite 419, Waterloo, IA 50702-5619 | 2006-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346877560 | Mandy Erpelding | Specialist | 3500 Dodge St Ste 105, Dubuque, IA 52003-5208 | 2020-03-26 |
| 1689209793 | Iowa Wellness Center PC | Specialist | 1395 Jordan St Ste C, North Liberty, IA 52317-4759 | 2020-03-09 |
| 1568011203 | Valeria V. Stickler | Specialist | 125 E Washington Street, Suite B, Clarinda, IA 51632 | 2019-09-05 |
| 1306379961 | Ted Schierer | Specialist | 8350 Ep True Parkway, Unit 1201, West Des Moines, IA 50266-8321 | 2017-04-10 |
| 1790147122 | Linda Kaye Renze | Specialist | 2795 100th St, Urbandale, IA 50322-3863 | 2016-03-24 |
| 1578953451 | Sarah Jane Riley | Specialist | 1840 S Gilbert, Iowa City, IA 52240-4340 | 2015-01-29 |
| 1689079931 | April Blong | Specialist | 1809 S Riverside Dr, Ames, IA 50011-3619 | 2014-10-29 |
| 1336558428 | Rebecca Ahrendsen | Specialist | 22301 312th St, Hinton, IA 51024-8859 | 2014-08-04 |
| 1114337748 | Amanda Lowe | Specialist | 3164 230th Street, Rose Hill, IA 52586 | 2014-05-05 |
| 1326467036 | Mat Eveleth | Specialist | 2001 Canal Shore Dr. Sw, Leclaire, IA 52753 | 2014-04-09 |
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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.