MRS. KELLIE GOEDKEN DEN HARTOG (NPI# 1992261002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992261002 |
| Entity Type | Individual |
| Full Name | MRS. KELLIE GOEDKEN DEN HARTOG |
| Other Name | KELLIE ANN GOEDKEN |
| Credential | PA-C |
| Practice Address |
1100 S 10th Ave Rock Rapids IA 51246-2020 |
| Mailing Address |
1363 Highway 9 Apt 5 Larchwood IA 51241-7585 |
| Practice Telephone | 7124725399 |
| Mailing Telephone | 7123483341 |
| Enumeration Date | 2019-02-13 |
| Last Update Date | 2019-02-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 095185 | IA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 800 S. Green Street, Rock Rapids, IA 51246 | 4026570664 |
| Street Address |
1100 S 10TH AVE |
| City | ROCK RAPIDS |
| State | IA |
| Zip Code | 51246-2020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245875590 | Alyssa Andrea Laleman | Pharmacist | 1100 S 10th Ave, Rock Rapids, IA 51246-2020 | 2019-11-11 |
| 1093288292 | Avera Mckennan | Medicare Defined Swing Bed Unit | 1100 S 10th Ave, Rock Rapids, IA 51246-2020 | 2019-01-10 |
| 1750854956 | Avera Mckennan | General Acute Care Hospital | 1100 S 10th Ave, Rock Rapids, IA 51246-2020 | 2019-01-10 |
| 1003389206 | Avera Mckennan | Clinic/Center | 1100 S 10th Ave, Ste 100, Rock Rapids, IA 51246-2020 | 2019-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992302566 | Naiyuan Zhang-lunser | Acupuncturist | 111th S Story St, Rock Rapids, IA 51246 | 2020-10-06 |
| 1912107996 | Brynn Ely Ladd | Physical Therapist | Merrill Pioneer Hospital, 801 S. Greene Ave., Rock Rapids, IA 51246 | 2007-07-19 |
| 1467550061 | Joseph Andrew Murphy | Dentist | 601 N 2nd Ave, Rock Rapids, IA 51246 | 2006-09-20 |
| 1093898066 | Kathryn Joan Ranschau | Physician Assistant | 803 S Greene St, Rock Rapids, IA 51246 | 2006-10-23 |
| 1306908280 | Robert James Degooyer | Hearing Instrument Specialist | 607 South Carroll Street, Park Rapids, IA 51246-0243 | 2006-12-15 |
| 1184024846 | Kayla White | Speech-Language Pathologist | 104 Buncombe Dr, Rock Rapids, IA 51246-1003 | 2014-09-01 |
| 1689271934 | Austyn Joan Thier | Physical Therapist | 104 Buncombe Dr, Rock Rapids, IA 51246-1003 | 2020-10-08 |
| 1396218244 | Sanford Clinic | Family Medicine | 104 Buncombe Dr, Rock Rapids, IA 51246-1003 | 2019-01-03 |
| 1538697164 | Sarah Jo Heinen | Family Medicine | 104 Buncombe Dr, Rock Rapids, IA 51246-1003 | 2017-05-26 |
| 1063489177 | Michael Lee Roetman | Optometrist | 502 1st Ave, Rock Rapids, IA 51246-1014 | 2006-03-07 |
| Find all providers in zip 51246 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376553040 | Beta Jo Hamon | Family Medicine | 803 S Greene St, Rock Rapids, IA 51246-1948 | 2006-08-08 |
| 1396218244 | Sanford Clinic | Family Medicine | 104 Buncombe Dr, Rock Rapids, IA 51246-1003 | 2019-01-03 |
| 1538697164 | Sarah Jo Heinen | Family Medicine | 104 Buncombe Dr, Rock Rapids, IA 51246-1003 | 2017-05-26 |
| 1235218215 | Sanford Health Network | Family Medicine | 803 S Greene St, Rock Rapids, IA 51246-1948 | 2006-11-02 |
| 1518040534 | Sriranjani Kasinathan | Family Medicine | 803 S Greene St, Rock Rapids, IA 51246-1948 | 2006-10-23 |
| 1649353681 | David James Springer | Family Medicine | 803 S Greene St, Rock Rapids, IA 51246-1948 | 2006-10-23 |
| 1952484909 | Chester Penn De Jong | Family Medicine | 803 S Greene St, Rock Rapids, IA 51246-1948 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639779283 | Melinda Heverly | Family Medicine | 6343 Sutton Dr, Urbandale, IA 50322-8053 | 2020-10-31 |
| 1215536636 | Darcie Marie Cook | Family Medicine | 8285 Turkey Valley Ln, Dubuque, IA 52003-9749 | 2020-10-19 |
| 1740896828 | Lisa Marie Swanson | Family Medicine | 1609 N Ankeny Blvd # 200, Ankeny, IA 50023-4159 | 2020-09-23 |
| 1003421959 | Elizabeth Ann Myhr | Family Medicine | 2680 Ne 102nd Ave, Ankeny, IA 50021-9224 | 2020-09-08 |
| 1407465917 | Qv Urgent Care Ia Pllc | Family Medicine | 801 North Grand Avenue, Mt. Pleasant, IA 52641 | 2020-07-30 |
| 1871101246 | Des Moines Regenerative Medicine Pllc | Family Medicine | 5901 Westown Pkwy Ste 220, West Des Moines, IA 50266-8297 | 2020-07-21 |
| 1346867439 | Kinza Ali | Family Medicine | 2055 Kimball Avenue, Suite 101, Waterloo, IA 50702 | 2020-07-06 |
| 1689291411 | Katie Weigel | Family Medicine | 635 W Washington St, Winthrop, IA 50682-9356 | 2020-06-27 |
| 1760005110 | Barbra Ellen Faux | Family Medicine | 1007 W 3rd Ave Apt 115, Indianola, IA 50125-3172 | 2020-05-20 |
| 1235764424 | Amber Dawn Hartman | Family Medicine | 20671 42nd St, Anamosa, IA 52205-7735 | 2020-03-08 |
| Find all providers with the same taxonomy | ||||
| City | ROCK RAPIDS |
| Zip Code | 51246 |
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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.