CONVENIENT CARE MEDICAL GROUP, PLLC (NPI# 1336523893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336523893 |
| Entity Type | Organization |
| Organization Name | CONVENIENT CARE MEDICAL GROUP, PLLC |
| Practice Address |
3502 Metro Drive Suite 200 Council Bluffs IA 51501-7724 |
| Practice Telephone | 7122567172 |
| Practice Fax Number | 7122567374 |
| Mailing Telephone | 7122567172 |
| Mailing Fax Number | 7122567374 |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2015-10-02 |
| Authorized Official Name | WYATT ALLEN SCHMIDT (PHYSICAIN ASSISTANT/MANAGER) |
| Authorized Official Telephone | 7122567172 |
| Authorized Official Credential | PA-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | A121973 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363A00000X | Physician Assistant | 002355 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | CONVENIENT CARE MEDICAL GROUP, PLLC | 3502 Metro Dr Ste 200, Council Bluffs, IA 51501 |
| Street Address |
3502 METRO DRIVE SUITE 200 |
| City | COUNCIL BLUFFS |
| State | IA |
| Zip Code | 51501-7724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215281282 | Wyatt Allen Schmidt | Physician Assistant | 3502 Metro Drive, Suite 200, Council Bluffs, IA 51501-7724 | 2012-10-30 |
| 1770906109 | Elizabeth Lorene Hinzmann | Nurse Practitioner | 3502 Metro Drive, Suite 200, Council Bluffs, IA 51501 | 2014-01-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881204691 | Melissa Sue Sperry | Counselor | Melissa Sperry, 4036 Ramelle Dr, Council Bluffs, IA 51501 | 2020-08-06 |
| 1326689076 | Crc Recovery, Inc. | Clinic/Center | 1750 W Broadway, Council Bluffs, IA 51501 | 2019-10-03 |
| 1518451152 | Naomi Kigondu | Registered Nurse | 2323 W Broadway Ste 100, Council Bluffs, IA 51501 | 2018-06-18 |
| 1710400361 | Travis John Alger | Chiropractor | 3424 W Broadway, Council Bluffs, IA 51501 | 2017-07-25 |
| 1124495692 | Jillian Kahl | Speech-Language Pathologist | 1500 N 16th St, Council Bluffs, IA 51501 | 2015-08-31 |
| 1932584323 | Leigh Healey | Dietitian, Registered | 2323 West Broadway, Council Bluffs, IA 51501 | 2015-07-27 |
| 1942558523 | Karen Irene Godin | Registered Nurse | 1702 N 16th Street, Council Bluffs, IA 51501 | 2012-08-29 |
| 1063787505 | Rebecca F Aboe | Dietitian, Registered | 1702 North 16th St., Council Bluffs, IA 51501 | 2012-03-16 |
| 1972883122 | Sara Ann Lott | Occupational Therapist | 1310 N. 17th St., Council Bluffs, IA 51501 | 2011-08-19 |
| 1700042884 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 3271 Marketplace Dr, Council Bluffs, IA 51501 | 2008-07-29 |
| Find all providers in zip 51501 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972124956 | Michaela J Maliszewski | Physician Assistant | 201 Ridge St Ste 302, Council Bluffs, IA 51503-4643 | 2020-05-01 |
| 1427396670 | Alexa Nicole Grzywa | Physician Assistant | 1 Edmundson Pl Ste 306, Council Bluffs, IA 51503-4620 | 2013-01-23 |
| 1215281282 | Wyatt Allen Schmidt | Physician Assistant | 3502 Metro Drive, Suite 200, Council Bluffs, IA 51501-7724 | 2012-10-30 |
| 1285791186 | Joyce Vacek | Physician Assistant | 2201 W Broadway Ste 9, Council Bluffs, IA 51501-3605 | 2007-01-02 |
| 1184657603 | Sara Rygol | Physician Assistant | 2201 W Broadway, Suite 9, Council Bluffs, IA 51501-3605 | 2006-07-08 |
| 1770558025 | Denise L Honner | Physician Assistant | 1604 2nd Ave, Council Bluffs, IA 51501 | 2006-02-21 |
| 1235761107 | Jared J Scherer | Physician Assistant | 1288 Valley View Dr, Council Bluffs, IA 51503-5245 | 2020-02-10 |
| 1427515402 | Katelyn C Birkett | Physician Assistant | 800 Mercy Dr, Council Bluffs, IA 51503-3128 | 2019-02-26 |
| 1972080331 | Nancy Hall Pettit | Physician Assistant | 320 Mckenzie Ave, Suite 201, Council Bluffs, IA 51503 | 2018-07-27 |
| 1689175093 | Brenna L Rasmussen | Physician Assistant | 800 Mercy Dr, Council Bluffs, IA 51503-3128 | 2018-02-22 |
| Find all providers in COUNCIL BLUFFS | ||||
| City | COUNCIL BLUFFS |
| Zip Code | 51501 |
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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.