| Community Health Center Of Fort Dodge Inc. | |
|
126 North 10th St Fort Dodge IA 50501-3915 | |
| (515) 576-6500 | |
| (515) 576-2021 |
| Full Name | Community Health Center Of Fort Dodge Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 126 North 10th St, Fort Dodge, Iowa |
| Authorized Official Name and Position | Renae Irene Elizabeth Kruckenberg (CEO) |
| Authorized Official Contact | 5155766500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Health Center Of Fort Dodge Inc. 126 North 10th St Fort Dodge IA 50501-3915 Ph: (515) 576-6500 | Community Health Center Of Fort Dodge Inc. 126 North 10th St Fort Dodge IA 50501-3915 Ph: (515) 576-6500 |
| NPI Number | 1225083728 |
|---|---|
| Provider Enumeration Date | 05/23/2006 |
| Last Update Date | 03/01/2023 |
| Medicare PECOS PAC ID | 1557378627 |
|---|---|
| Medicare Enrollment ID | O20070104000109 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225083728 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Iowa) | Primary |
| Provider Name | Angela J Mcgregor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366474132 PECOS PAC ID: 0244209278 Enrollment ID: I20040928000023 |
| Provider Name | Nicolle L Medina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528150661 PECOS PAC ID: 9234157496 Enrollment ID: I20051108000047 |
| Provider Name | Elizabeth W Stoebe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992780365 PECOS PAC ID: 3375451677 Enrollment ID: I20060104000119 |
| Provider Name | Janet E Secor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558333898 PECOS PAC ID: 1658429915 Enrollment ID: I20090427000221 |
| Provider Name | Ann M Feser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245591288 PECOS PAC ID: 1850547027 Enrollment ID: I20120804000037 |
| Provider Name | Holly A Mcclintock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558656876 PECOS PAC ID: 3274783915 Enrollment ID: I20121015000737 |
| Provider Name | Jennifer L Pudenz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295081263 PECOS PAC ID: 3678724499 Enrollment ID: I20121103000004 |
| Provider Name | Bonni L Herpst |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437468170 PECOS PAC ID: 1456593649 Enrollment ID: I20130819000487 |
| Provider Name | Cindy S Pontious |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770925935 PECOS PAC ID: 0648404848 Enrollment ID: I20131001000201 |
| Provider Name | Kendra S Ulicki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275972283 PECOS PAC ID: 7012141195 Enrollment ID: I20131002000680 |
| Provider Name | Lisa K Chase |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023377827 PECOS PAC ID: 2668606393 Enrollment ID: I20131010001953 |
| Provider Name | Terrilee N Jackel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245634401 PECOS PAC ID: 4981928488 Enrollment ID: I20150109000762 |
| Provider Name | Kirsten J Olson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780956094 PECOS PAC ID: 4183945603 Enrollment ID: I20150609000647 |
| Provider Name | Sara E Kuhn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225414576 PECOS PAC ID: 0547578767 Enrollment ID: I20151007001606 |
| Provider Name | Jennifer S Zigrang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699134072 PECOS PAC ID: 9133406622 Enrollment ID: I20170510002573 |
| Provider Name | Deborah L Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124044573 PECOS PAC ID: 3971756891 Enrollment ID: I20170510002701 |
| Provider Name | Taylor Lynn Stille |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336661677 PECOS PAC ID: 2961773353 Enrollment ID: I20170803000678 |
| Provider Name | Robert E Joneson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346637527 PECOS PAC ID: 7012283898 Enrollment ID: I20171023001487 |
| Provider Name | Helen H Retleff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760996292 PECOS PAC ID: 6709145972 Enrollment ID: I20180116000191 |
| Provider Name | Kari L Tessum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508374927 PECOS PAC ID: 6103187372 Enrollment ID: I20180302002300 |
| Provider Name | Megan Lakshmi Srinivas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710397179 PECOS PAC ID: 5395010144 Enrollment ID: I20181001000915 |
| Provider Name | Eileen Meier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851847883 PECOS PAC ID: 4082993795 Enrollment ID: I20190107002793 |
| Provider Name | Lynzy M Devary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598307647 PECOS PAC ID: 2961834072 Enrollment ID: I20191111003038 |
| Provider Name | Carol A Ogea |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013918051 PECOS PAC ID: 1557793353 Enrollment ID: I20191116000217 |
| Provider Name | Erica S Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841803616 PECOS PAC ID: 5193142255 Enrollment ID: I20200903001491 |
| Provider Name | Laurel Faltas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902437940 PECOS PAC ID: 2365860020 Enrollment ID: I20200911001005 |
| Provider Name | Kjerstin L Mosby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659969970 PECOS PAC ID: 2264847037 Enrollment ID: I20210209002679 |
| Provider Name | Kristen Michelle Molander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053755223 PECOS PAC ID: 8527463843 Enrollment ID: I20210825002060 |
| Provider Name | Kellie Jo Enderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316523459 PECOS PAC ID: 6103216296 Enrollment ID: I20211203001312 |
| Provider Name | Brittany J Allen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801539986 PECOS PAC ID: 7517354442 Enrollment ID: I20220425001004 |
| Provider Name | Brian Edward Ayersman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689325524 PECOS PAC ID: 0547649311 Enrollment ID: I20220624001235 |
| Provider Name | Tayler M Rasch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184341711 PECOS PAC ID: 2860860244 Enrollment ID: I20221115002953 |
| Provider Name | Katie Jo Riehl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699483404 PECOS PAC ID: 3870964885 Enrollment ID: I20230130000229 |
| Provider Name | Bailey Schutz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346940830 PECOS PAC ID: 7618341207 Enrollment ID: I20230322001368 |
| Provider Name | Roxanne Fevold |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558752766 PECOS PAC ID: 5294148201 Enrollment ID: I20231121001480 |
| Provider Name | Angela Crosby |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538544309 PECOS PAC ID: 2668853581 Enrollment ID: I20231214000324 |
Unitypoint Clinic Family Medicine Second Avenue North Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1428 2nd Ave N, Fort Dodge, IA 50501 Phone: 515-574-6110 Fax: 515-573-3908 | |
Unitypoint Clinic-pediatrics-fort Dodge Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 804 Kenyon Rd, Ste D, Fort Dodge, IA 50501 Phone: 515-574-6855 Fax: 515-573-7274 | |
North Central Occupational Medicine & Walk In Clinic,pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 30 N 27th St, Fort Dodge, IA 50501 Phone: 713-358-3054 | |
Active Health Clinics Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 20 N 29th St, Fort Dodge, IA 50501 Phone: 515-227-7491 | |
Unitypoint Clinic Pediatrics Fort Dodge Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 804 Kenyon Rd, Ste D, Fort Dodge, IA 50501 Phone: 515-574-6855 Fax: 515-573-7274 | |
North Central Iowa Mental Health Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 720 Kenyon Rd, Fort Dodge, IA 50501 Phone: 800-482-8305 Fax: 515-573-7898 |