| The Childserve Clinic Inc | |
|
5406 Merle Hay Rd Johnston IA 50131-1209 | |
| (515) 727-8750 | |
| (515) 727-8757 |
| Full Name | The Childserve Clinic Inc |
|---|---|
| Speciality | Pediatrics |
| Location | 5406 Merle Hay Rd, Johnston, Iowa |
| Authorized Official Name and Position | Jennifer Pavlovec (DIRECTOR OF FINANCE) |
| Authorized Official Contact | 5157271463 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Childserve Clinic Inc Po Box 707 Johnston IA 50131-0707 Ph: (515) 727-8750 | The Childserve Clinic Inc 5406 Merle Hay Rd Johnston IA 50131-1209 Ph: (515) 727-8750 |
| NPI Number | 1033449145 |
|---|---|
| Provider Enumeration Date | 01/12/2010 |
| Last Update Date | 10/08/2020 |
| Certification Date | 10/08/2020 |
| Medicare PECOS PAC ID | 4082034913 |
|---|---|
| Medicare Enrollment ID | O20201015000700 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033449145 | NPI | - | NPPES |
| Provider Name | Leah J Brandon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417214321 PECOS PAC ID: 1456654995 Enrollment ID: I20161222001579 |
| Provider Name | Fredrick T Klingbeil |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1346291184 PECOS PAC ID: 2365411527 Enrollment ID: I20190909003786 |
| Provider Name | Randalyn Rae Parker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265849673 PECOS PAC ID: 8426380411 Enrollment ID: I20191023003606 |
| Provider Name | Hannah Marie Slaughter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508288275 PECOS PAC ID: 9638580905 Enrollment ID: I20201118002008 |
| Provider Name | Maria Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417624966 PECOS PAC ID: 4880073840 Enrollment ID: I20220622000178 |
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