PATRICK J PUCELIK (NPI# 1649247362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649247362 |
| Entity Type | Individual |
| Full Name | PATRICK J PUCELIK |
| Credential | ARNP |
| Practice Address |
153 Blair St Whiting IA 51063-1007 |
| Practice Telephone | 7124552431 |
| Practice Fax Number | 7124552698 |
| Mailing Telephone | 7124552431 |
| Mailing Fax Number | 7124552698 |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2008-05-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208D00000X | General Practice | A-106028 | IA | Allopathic & Osteopathic Physicians |
| Y | 363L00000X | Nurse Practitioner | A-106028 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD MEDICARE | 500018631 | 01 |
| Street Address |
153 BLAIR ST |
| City | WHITING |
| State | IA |
| Zip Code | 51063-1007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487022216 | Burgess Health Center | Surgery | 153 Blair St, Whiting, IA 51063-1007 | 2015-09-10 |
| 1669692380 | J. L. Garred, Sr., M.d.p.c. | Surgery | 153 Blair St, Whiting, IA 51063-1007 | 2007-04-26 |
| 1770550196 | John L Garred Jr. | Surgery | 153 Blair St, Whiting, IA 51063-1007 | 2006-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134269590 | City of Whiting | Ambulance | 513 Whittier St., Whiting, IA 51063 | 2007-02-07 |
| 1588711139 | Whiting Community Schools | Local Education Agency (LEA) | 606 West Street, Whiting, IA 51063 | 2007-01-05 |
| 1649266842 | Whiting Commercial Development Corp | Assisted Living Facility | 200 Shannon Dr., Whiting, IA 51063 | 2005-09-22 |
| 1336525161 | Crystal Scott | Physical Therapy Assistant | 200 Shannon Dr, Whiting, IA 51063-1021 | 2015-08-04 |
| 1699844548 | Burgess Health Center | Pharmacy | 723 Whittier St, Whiting, IA 51063-1035 | 2006-11-07 |
| 1891911442 | Sandra Rose | Pharmacist | 723 Whittier St, Whiting, IA 51063-1035 | 2007-04-18 |
| 1174983167 | Jennifer Shilling | Chiropractor | 920 Kester St, Whiting, IA 51063-7731 | 2016-03-03 |
| 1891026597 | Erin Tania Anderson | Social Worker | 15838 Highway K42, Whiting, IA 51063-8745 | 2010-01-19 |
| 1053827477 | Roots and Wings Therapy | Clinic/Center | 15838 Highway K42, Whiting, IA 51063-8745 | 2017-12-20 |
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992254619 | Victoria Urdov | Nurse Practitioner | 2075 Indianapolis Blvd, Whiting, IN 46394-1948 | 2016-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912508722 | Tlc Healthcare LLC | Nurse Practitioner | 202 N Main St Ste A, Monticello, IA 52310-1746 | 2020-11-06 |
| 1679187108 | Jolene M. Mcadam | Nurse Practitioner | 536 Meadow Oak Cir, Fairfax, IA 52228-4709 | 2020-09-02 |
| 1427662832 | Schreiber Health Services Pllc | Nurse Practitioner | 8450 Hickman Rd Ste 16, Clive, IA 50325-4307 | 2020-09-02 |
| 1720606841 | Kristen Roberts | Nurse Practitioner | 108 Monroe St, Grand River, IA 50108-7510 | 2020-07-07 |
| 1437776747 | Michelle Gillitzer | Nurse Practitioner | 2450 Coral Ct, Coralville, IA 52241-2975 | 2020-07-02 |
| 1487271904 | Lynette Prickett | Nurse Practitioner | 15346 Dodgeville Rd, Sperry, IA 52650-9623 | 2020-06-30 |
| 1891311650 | Tiffany Amber Zieser | Nurse Practitioner | 1383 Fontana Blvd, Hazleton, IA 50641-5064 | 2020-06-17 |
| 1790300648 | Kdp Management Services LLC | Nurse Practitioner | 7109 Holcomb Ave, Urbandale, IA 50322-4740 | 2020-06-16 |
| 1982228920 | Samantha Quelland | Nurse Practitioner | 4090 Westown Pkwy # 106, West Des Moines, IA 50266-6760 | 2020-06-05 |
| 1841823622 | Melissa Lynn Coulter | Nurse Practitioner | 202 10th St Se Ste 165, Cedar Rapids, IA 52403-2433 | 2020-02-19 |
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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.