Family Health Center of Waterloo, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FAMILY HEALTH CENTER OF WATERLOO, P.C.

Practice address

220 W Ridgeway Ave
Suite 106
Waterloo, IA 50701-4200

Phone

(319) 226-4400

Fax

(319) 226-4401

NPI assigned

Jun 27, 2007

Last updated

Dec 16, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ellen L. SakornbutNPI 1578567947

Title

Owner

Phone

(319) 226-4400

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ellen Louise Sakornbut, MD

  • Family Medicine Physician
  • Waterloo, IA
  • NPI 1578567947
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260921600000",
    "number": "1003013731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 W RIDGEWAY AVE",
            "address_2": "SUITE 106",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507014200",
            "telephone_number": "319-226-4400",
            "fax_number": "319-226-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 W RIDGEWAY AVE",
            "address_2": "SUITE 106",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507014200",
            "telephone_number": "319-226-4400",
            "fax_number": "319-226-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTER OF WATERLOO, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2009-12-16",
        "status": "A",
        "authorized_official_last_name": "SAKORNBUT",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-226-4400"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.