| Essence Med Llc | |
|
3424 W Broadway Council Bluffs IA 51501-3211 | |
| (712) 796-3481 | |
| Not Available |
| Full Name | Essence Med Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3424 W Broadway, Council Bluffs, Iowa |
| Authorized Official Name and Position | Travis Alger (OWNER) |
| Authorized Official Contact | 7123300388 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Essence Med Llc 3424 W Broadway Council Bluffs IA 51501-3211 Ph: (712) 796-3481 | Essence Med Llc 3424 W Broadway Council Bluffs IA 51501-3211 Ph: (712) 796-3481 |
| NPI Number | 1750952875 |
|---|---|
| Provider Enumeration Date | 07/09/2021 |
| Last Update Date | 07/09/2021 |
| Medicare PECOS PAC ID | 1355746686 |
|---|---|
| Medicare Enrollment ID | O20210824002162 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750952875 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| Provider Name | Donella Raye Chadwick-kermeen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164089025 PECOS PAC ID: 7416372529 Enrollment ID: I20200806002397 |
| Provider Name | Caitlin Carlson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023686508 PECOS PAC ID: 4082019310 Enrollment ID: I20210825002558 |
| Provider Name | Seth Dinowitz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336186667 PECOS PAC ID: 6608788328 Enrollment ID: I20211027001181 |
| Provider Name | Bob L Crow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518267822 PECOS PAC ID: 9234327172 Enrollment ID: I20221207000342 |
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