| Mercy Care Edgewood | |
|
2815 Edgewood Rd Sw Cedar Rapids IA 52404-3258 | |
| (319) 369-4798 | |
| Not Available |
| Full Name | Mercy Care Edgewood |
|---|---|
| Speciality | Family Medicine |
| Location | 2815 Edgewood Rd Sw, Cedar Rapids, Iowa |
| Authorized Official Name and Position | Annette J Stanton (SR DIRECTOR) |
| Authorized Official Contact | 3193694512 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Care Edgewood Po Box 1824 Cedar Rapids IA 52406-1824 | Mercy Care Edgewood 2815 Edgewood Rd Sw Cedar Rapids IA 52404-3258 Ph: (319) 369-4798 |
| NPI Number | 1427254952 |
|---|---|
| Provider Enumeration Date | 06/22/2007 |
| Last Update Date | 02/01/2011 |
| Medicare PECOS PAC ID | 1355242496 |
|---|---|
| Medicare Enrollment ID | O20040120000805 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427254952 | NPI | - | NPPES |
| 0148049 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Sudha R Anand |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992765002 PECOS PAC ID: 6406752617 Enrollment ID: I20031209000734 |
| Provider Name | Timothy J Sagers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598725616 PECOS PAC ID: 3375449424 Enrollment ID: I20031209001037 |
| Provider Name | Vincent a Taeger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770659591 PECOS PAC ID: 0941109359 Enrollment ID: I20040105000823 |
| Provider Name | Timothy J Quinn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548220668 PECOS PAC ID: 3678464310 Enrollment ID: I20040323000513 |
| Provider Name | Peter B Ahn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063416394 PECOS PAC ID: 7719878909 Enrollment ID: I20040324001694 |
| Provider Name | Bradley J Beer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497715676 PECOS PAC ID: 3476445032 Enrollment ID: I20040327000298 |
| Provider Name | Jerry L Wille |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598733891 PECOS PAC ID: 3678568466 Enrollment ID: I20040420000441 |
| Provider Name | Diane S Norton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598724973 PECOS PAC ID: 1951391408 Enrollment ID: I20040517000039 |
| Provider Name | Jami a Maxson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467504506 PECOS PAC ID: 2961483664 Enrollment ID: I20040527001246 |
| Provider Name | Monica a Meeker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578559829 PECOS PAC ID: 2466424601 Enrollment ID: I20040809001250 |
| Provider Name | John Ervin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1588757736 PECOS PAC ID: 6305899907 Enrollment ID: I20050223000624 |
| Provider Name | Tony a Myers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407835283 PECOS PAC ID: 1850339870 Enrollment ID: I20050420000952 |
| Provider Name | Sherri L Vesely |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053398974 PECOS PAC ID: 7719912203 Enrollment ID: I20051004000415 |
| Provider Name | Stephen L Runde |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780644286 PECOS PAC ID: 2860418076 Enrollment ID: I20051018000185 |
| Provider Name | Julie J Hoffmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225004161 PECOS PAC ID: 8022038397 Enrollment ID: I20051201000240 |
| Provider Name | Melanie K Stahlberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851353676 PECOS PAC ID: 3476563669 Enrollment ID: I20060503000060 |
| Provider Name | Trisha L Sheeley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194772079 PECOS PAC ID: 8426069584 Enrollment ID: I20060606000130 |
| Provider Name | Fadi Y Yacoub |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1285690412 PECOS PAC ID: 6800808932 Enrollment ID: I20060608000034 |
| Provider Name | Carrie C Brown-benn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306854781 PECOS PAC ID: 4688679210 Enrollment ID: I20061003000438 |
| Provider Name | Tami J Feickert |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1174623235 PECOS PAC ID: 4880692219 Enrollment ID: I20061120000312 |
| Provider Name | Renee E Nydegger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154311728 PECOS PAC ID: 4385540905 Enrollment ID: I20061213000073 |
| Provider Name | Kristen Jean Bockenstedt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275617854 PECOS PAC ID: 1850390139 Enrollment ID: I20061214000213 |
| Provider Name | Ann Katherine Soenen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730199431 PECOS PAC ID: 9436158490 Enrollment ID: I20061220000520 |
| Provider Name | Jessica J Quinn |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1841368800 PECOS PAC ID: 0547363632 Enrollment ID: I20070309000382 |
| Provider Name | Kara S Goslin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1912070905 PECOS PAC ID: 0446354823 Enrollment ID: I20070323000239 |
| Provider Name | Heidi G Dahlem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619001781 PECOS PAC ID: 3375634256 Enrollment ID: I20070807000303 |
| Provider Name | Gregory P Taylor |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962431593 PECOS PAC ID: 0749288645 Enrollment ID: I20070814000201 |
| Provider Name | Keri L Mounce |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043304736 PECOS PAC ID: 6406951656 Enrollment ID: I20070814000404 |
| Provider Name | Amanda L Heck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578777231 PECOS PAC ID: 9335230788 Enrollment ID: I20070814000558 |
| Provider Name | Michael Hugh Wallace |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801982475 PECOS PAC ID: 8224004973 Enrollment ID: I20070827000810 |
| Provider Name | Wendy S Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124216676 PECOS PAC ID: 2365539574 Enrollment ID: I20071106000131 |
| Provider Name | Erika Siska |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750583605 PECOS PAC ID: 6002905726 Enrollment ID: I20071204000254 |
| Provider Name | Lorita L Phillips |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1346236460 PECOS PAC ID: 2769563477 Enrollment ID: I20080121000038 |
| Provider Name | Tod M Walker |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1942485560 PECOS PAC ID: 6002990801 Enrollment ID: I20080303000363 |
| Provider Name | Anwar Ahmed |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1154377463 PECOS PAC ID: 4880699560 Enrollment ID: I20080508000325 |
| Provider Name | Laurie L Pieper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508915703 PECOS PAC ID: 9537230560 Enrollment ID: I20080619000354 |
| Provider Name | Jacquelyn W Zillman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1528220555 PECOS PAC ID: 4183799513 Enrollment ID: I20080820000422 |
| Provider Name | Angela D Dolphin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1184619611 PECOS PAC ID: 8224198080 Enrollment ID: I20081124000475 |
| Provider Name | Arun Kumar Movva |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1780769109 PECOS PAC ID: 0244391738 Enrollment ID: I20081202000610 |
| Provider Name | Stephanie E Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811141765 PECOS PAC ID: 3577624774 Enrollment ID: I20081205000668 |
| Provider Name | Tonya J Hasleiet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033363205 PECOS PAC ID: 7618030107 Enrollment ID: I20090109000188 |
| Provider Name | Anna M Dempewolf |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1124002555 PECOS PAC ID: 6103980990 Enrollment ID: I20090122000451 |
| Provider Name | Lindsey L Robb |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1639307069 PECOS PAC ID: 2567518095 Enrollment ID: I20090924000116 |
| Provider Name | Madonna S Carr |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619153608 PECOS PAC ID: 7113097437 Enrollment ID: I20090925000324 |
| Provider Name | Matthew G Fox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780644849 PECOS PAC ID: 8123163805 Enrollment ID: I20100305000313 |
| Provider Name | Casey J Boyles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669459921 PECOS PAC ID: 3678608866 Enrollment ID: I20100312000511 |
| Provider Name | Shannon C Throndson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982682621 PECOS PAC ID: 3274669684 Enrollment ID: I20100324000972 |
| Provider Name | John J Klein |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184684854 PECOS PAC ID: 5799811543 Enrollment ID: I20100331000285 |
| Provider Name | John R Brownell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861452633 PECOS PAC ID: 3375679137 Enrollment ID: I20100331000338 |
| Provider Name | Robert J Schultes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568438646 PECOS PAC ID: 1052447836 Enrollment ID: I20100331000611 |
| Provider Name | Colleen L Keating |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295701373 PECOS PAC ID: 7214063007 Enrollment ID: I20100331000638 |
| Provider Name | Amy E Andersen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932169778 PECOS PAC ID: 5395871180 Enrollment ID: I20100331000646 |
| Provider Name | Michael Slavin |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1194753806 PECOS PAC ID: 2163510389 Enrollment ID: I20100513000201 |
| Provider Name | Shane Arden Kasner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912966763 PECOS PAC ID: 6709914674 Enrollment ID: I20100513000695 |
| Provider Name | Paul Charles Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427026749 PECOS PAC ID: 7315075280 Enrollment ID: I20100513000717 |
| Provider Name | John E Lancaster |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487622098 PECOS PAC ID: 6406984384 Enrollment ID: I20100513000741 |
| Provider Name | Jason W Booth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861460495 PECOS PAC ID: 1254469133 Enrollment ID: I20100513000814 |
| Provider Name | Joseph J Kennedy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427019561 PECOS PAC ID: 1658409487 Enrollment ID: I20100514000362 |
| Provider Name | Kristen D Barnette |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134180276 PECOS PAC ID: 0749319101 Enrollment ID: I20100522000080 |
| Provider Name | Andrew P Patterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235190372 PECOS PAC ID: 7911036371 Enrollment ID: I20100522000088 |
| Provider Name | Todd a Pentico |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457399941 PECOS PAC ID: 6608907860 Enrollment ID: I20100701000734 |
| Provider Name | Thomas G Drahos |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1982918488 PECOS PAC ID: 4880718436 Enrollment ID: I20100902000931 |
| Provider Name | Nancy a Boelter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629015177 PECOS PAC ID: 0941498810 Enrollment ID: I20101217000910 |
| Provider Name | Debra a Rohr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275812554 PECOS PAC ID: 7113197385 Enrollment ID: I20110825000233 |
| Provider Name | Joni K Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902111503 PECOS PAC ID: 0143497834 Enrollment ID: I20120120000454 |
| Provider Name | Michael Gomendoza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174637110 PECOS PAC ID: 3375437403 Enrollment ID: I20120514000186 |
| Provider Name | Carol Ann C Tan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356455398 PECOS PAC ID: 0840184818 Enrollment ID: I20120514000378 |
| Provider Name | Laura M Mclaughlin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972871416 PECOS PAC ID: 0446404685 Enrollment ID: I20130215000527 |
| Provider Name | Rhonda a Bridgewater |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073866331 PECOS PAC ID: 8729232970 Enrollment ID: I20130218000011 |
| Provider Name | Meghan M Cooley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851730238 PECOS PAC ID: 1153564646 Enrollment ID: I20130903000200 |
| Provider Name | Daniel J Howlett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326488420 PECOS PAC ID: 3577791482 Enrollment ID: I20140122000406 |
| Provider Name | Melanie M Blais |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407890155 PECOS PAC ID: 8628030095 Enrollment ID: I20140128001309 |
| Provider Name | Treesa a Silver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134421837 PECOS PAC ID: 7416187885 Enrollment ID: I20140304001111 |
| Provider Name | Jaclyn M Price |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417255340 PECOS PAC ID: 4284853912 Enrollment ID: I20140911001584 |
| Provider Name | Kristin L Gisselman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467890988 PECOS PAC ID: 4587987375 Enrollment ID: I20150204000720 |
| Provider Name | Christa a Slagle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629478581 PECOS PAC ID: 3678890498 Enrollment ID: I20150316001373 |
| Provider Name | Nicholas O Bingham |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1861697609 PECOS PAC ID: 2062723281 Enrollment ID: I20150615001746 |
| Provider Name | Carly Y Roskop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083096663 PECOS PAC ID: 3779896857 Enrollment ID: I20150717002374 |
| Provider Name | Kimberly P Ferrante |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1083080980 PECOS PAC ID: 8820307382 Enrollment ID: I20151022002790 |
| Provider Name | Jamie S Hada |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093188872 PECOS PAC ID: 2466752811 Enrollment ID: I20151208000565 |
| Provider Name | Jennifer L Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417314683 PECOS PAC ID: 3971807173 Enrollment ID: I20160209001570 |
| Provider Name | Susan a Shea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356791610 PECOS PAC ID: 0840585444 Enrollment ID: I20160822001388 |
| Provider Name | Liv M Kelley-sellnau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891243499 PECOS PAC ID: 6305126418 Enrollment ID: I20161207001232 |
| Provider Name | Elizabeth J Meyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700323862 PECOS PAC ID: 6204110919 Enrollment ID: I20170224000373 |
| Provider Name | Stephanie a Moon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447781448 PECOS PAC ID: 6002193075 Enrollment ID: I20170428000866 |
| Provider Name | Stephanie L Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467973420 PECOS PAC ID: 5294006938 Enrollment ID: I20170731000198 |
| Provider Name | Joseph a Kussatz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487175691 PECOS PAC ID: 8527339399 Enrollment ID: I20170814000516 |
| Provider Name | Tyler P Kempf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730601428 PECOS PAC ID: 4880967900 Enrollment ID: I20170911003059 |
| Provider Name | Brenda F Murphy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104904259 PECOS PAC ID: 8123013596 Enrollment ID: I20171004002037 |
| Provider Name | Kim L Keiser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912425380 PECOS PAC ID: 2668747270 Enrollment ID: I20171009000449 |
| Provider Name | Brendan D Leiran |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1174031819 PECOS PAC ID: 8022378678 Enrollment ID: I20180131000320 |
| Provider Name | Kara M Fort |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376059360 PECOS PAC ID: 7618239443 Enrollment ID: I20180315000073 |
| Provider Name | Chad M Proctor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194222711 PECOS PAC ID: 1759645187 Enrollment ID: I20180510001024 |
| Provider Name | Sarah a Doyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861972424 PECOS PAC ID: 6709139942 Enrollment ID: I20181105002720 |
| Provider Name | Shelby M Meyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750857264 PECOS PAC ID: 5294070058 Enrollment ID: I20181222000466 |
| Provider Name | Amanda L Brenneman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639658800 PECOS PAC ID: 5092051656 Enrollment ID: I20190118000733 |
| Provider Name | Megan M O'brien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760038509 PECOS PAC ID: 7810320173 Enrollment ID: I20191127002540 |
| Provider Name | Lindsay N Ehlers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316586159 PECOS PAC ID: 0143658773 Enrollment ID: I20200313002020 |
| Provider Name | Lynnette Lea Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194357830 PECOS PAC ID: 3971931296 Enrollment ID: I20200320001129 |
| Provider Name | Erica a Quigley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952935082 PECOS PAC ID: 8820427867 Enrollment ID: I20200326002353 |
| Provider Name | Rohan K Penmetcha |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1841603172 PECOS PAC ID: 0749601938 Enrollment ID: I20200526000784 |
| Provider Name | Jenifer M Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588288385 PECOS PAC ID: 8729403365 Enrollment ID: I20200730000704 |
| Provider Name | Ryan M Winder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093320392 PECOS PAC ID: 1052722378 Enrollment ID: I20201117003352 |
| Provider Name | Jerud R Cozine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508431321 PECOS PAC ID: 8123420064 Enrollment ID: I20210714002087 |
| Provider Name | Amelia M Wenner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851966808 PECOS PAC ID: 5193129195 Enrollment ID: I20210813000289 |
| Provider Name | Nicole J Sporrer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942821244 PECOS PAC ID: 4789081167 Enrollment ID: I20210928001742 |
| Provider Name | Theresa J Hallengren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861161267 PECOS PAC ID: 6406254929 Enrollment ID: I20211013001118 |
| Provider Name | Brandy Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871263095 PECOS PAC ID: 9234527482 Enrollment ID: I20211021000497 |
| Provider Name | Jaclyn R Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629730684 PECOS PAC ID: 9234527193 Enrollment ID: I20211026000737 |
| Provider Name | Sonya C Howald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306514898 PECOS PAC ID: 2668860206 Enrollment ID: I20211101000918 |
| Provider Name | Benjamin D Nordby |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972765402 PECOS PAC ID: 2769661412 Enrollment ID: I20220425001460 |
| Provider Name | Jonatan D Nunez Breton |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1780090241 PECOS PAC ID: 7113324807 Enrollment ID: I20220425001464 |
| Provider Name | Carson E Hayden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730824079 PECOS PAC ID: 1456738988 Enrollment ID: I20220521000239 |
| Provider Name | Miruais S Hamed |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1437291465 PECOS PAC ID: 5395990154 Enrollment ID: I20220801000443 |
| Provider Name | Carrie H Bayles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578294104 PECOS PAC ID: 5698157105 Enrollment ID: I20220801000538 |
| Provider Name | Stephanie M Lukaszka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073248316 PECOS PAC ID: 8628451010 Enrollment ID: I20220817003385 |
| Provider Name | Alexis D Vincent |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1609588672 PECOS PAC ID: 3779955380 Enrollment ID: I20230208001351 |
| Provider Name | Valerie Pena Polanco |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063064426 PECOS PAC ID: 7416317532 Enrollment ID: I20230720000782 |
| Provider Name | Calli D Snyder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649955642 PECOS PAC ID: 4880054956 Enrollment ID: I20230720002990 |
| Provider Name | Mary M Cannon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174209647 PECOS PAC ID: 5092178624 Enrollment ID: I20230830002718 |
| Provider Name | Jennifer S Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396425047 PECOS PAC ID: 6103272406 Enrollment ID: I20231023002305 |
| Provider Name | Emily K Aukes |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1770168684 PECOS PAC ID: 3577904838 Enrollment ID: I20240517000189 |
| Provider Name | Hima B Doppalapudi |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1154975928 PECOS PAC ID: 9537496807 Enrollment ID: I20240612004404 |
| Provider Name | Nicholas D Fisher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780427377 PECOS PAC ID: 2769921899 Enrollment ID: I20240903002487 |
| Provider Name | Linda a Mitchell |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1780003285 PECOS PAC ID: 9436684404 Enrollment ID: I20241127002514 |
| Provider Name | Mallory a Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316448418 PECOS PAC ID: 5092243766 Enrollment ID: I20250108002115 |
| Provider Name | Margaret Riddell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033913611 PECOS PAC ID: 6103335070 Enrollment ID: I20250602003404 |
| Provider Name | Timothy B Formanek |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1598718215 PECOS PAC ID: 3577688910 Enrollment ID: I20250617003061 |
| Provider Name | Mackenzie J Shisler |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1669274932 PECOS PAC ID: 9335636273 Enrollment ID: I20251014004335 |
| Provider Name | Alyssa T Ray |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073251583 PECOS PAC ID: 8022499383 Enrollment ID: I20251020001364 |
| Provider Name | Kennedy Smith |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1467274118 PECOS PAC ID: 7113400953 Enrollment ID: I20260310004465 |
| Provider Name | Katheryn Ro Kolker |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1063377018 PECOS PAC ID: 9335624691 Enrollment ID: I20260403001635 |
| Provider Name | Samuel C Kitzman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1194680140 PECOS PAC ID: 2769958412 Enrollment ID: I20260420002214 |
| Provider Name | Rorisang P Morobe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023702909 PECOS PAC ID: 9133690175 Enrollment ID: I20260610000980 |
| Provider Name | Devin Putz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669336863 PECOS PAC ID: 5698246668 Enrollment ID: I20260610001729 |
Bae Cedar Rapids Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7825 6th St Sw, Cedar Rapids, IA 52404 Phone: 615-468-3188 |
Family Chiropractic Wellness Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3150 E Ave Nw, Suite 101, Cedar Rapids, IA 52405 Phone: 319-390-2970 Fax: 319-390-2959 |
Abbe Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 520 11th St Nw, Cedar Rapids, IA 52405 Phone: 319-730-7300 |
Family Medicine Specialists, P.C. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 500 8th Ave Se, Cedar Rapids, IA 52401 Phone: 319-364-8704 Fax: 319-365-7747 |
Mercycare Health Partners Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 600 7th St Se, Suite 101, Cedar Rapids, IA 52401 Phone: 319-221-8627 Fax: 319-221-8563 |
Mary Nelson MD PC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 411 10th St Se, Suite 1400, Cedar Rapids, IA 52403 Phone: 319-365-8616 Fax: 319-297-7377 |