Premier Healthcare of Shenandoah, P.C.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

PREMIER HEALTHCARE OF SHENANDOAH, P.C.

Practice address

813 Church St
Shenandoah, IA 51601-2301

Phone

(712) 246-5954

Fax

(712) 246-3269

NPI assigned

Jun 5, 2018

Organization subpart

No

Name

Jeffrey P McCoy, D.C.NPI 1508804485

Title

President/Owner

Phone

(712) 246-5954

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey P McCoy, D.C.

  • Chiropractor
  • Shenandoah, IA
  • NPI 1508804485

  IA

  Medicare reassignment Care Compare group NPD Authorized official
• Kristin J Golden, ARNP

  • Family Nurse Practitioner
  • Tabor, IA
  • NPI 1386032761

  Family, IA

  Medicare reassignment Care Compare group NPD
• Michael George Kuderer, D.C.

  • Chiropractor
  • Stewartville, MN
  • NPI 1578722047

  IA

  Medicare reassignment Care Compare group NPD

Medicare fee-for-service enrollment

Enrolled in IA

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 23, 2018.

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534982400000",
    "number": "1003308149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 CHURCH ST",
            "city": "SHENANDOAH",
            "state": "IA",
            "postal_code": "516012301",
            "telephone_number": "712-246-5954",
            "fax_number": "712-246-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 CHURCH ST",
            "city": "SHENANDOAH",
            "state": "IA",
            "postal_code": "516012301",
            "telephone_number": "712-246-5954",
            "fax_number": "712-246-3269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER HEALTHCARE OF SHENANDOAH, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-05",
        "last_updated": "2018-08-23",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "712-246-5954",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Page County
• Joyce Portz Ann Portz, RN
• Matthew Paul Potratz, D.C.
• Precision Braces Diagnostics LLC
• Premier Estates 509, LLC
• Premier Host Homes, LLC
• Premier Waiver Homes LLC
• Pure Therapy
• Renal Treatment Centers-Illinois Inc
• Ashlee Jo Richardson, PT, DPT

• All providers in Shenandoah, IA
• Family Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.