Individual provider Active NPI

Catherine P McNeill, M.D.

  • Pediatrics Physician
  • Des Moines, IA
National Provider Identifier
1003824822
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD-42833 Issued in IA
Practice address
1200 Pleasant St
Des Moines, IA 50309-1406
Phone
(515) 241-6611
Fax
(515) 241-6635
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036096723 IL
Pediatrics Physician 208000000X MD-42833 IA Primary

Addresses

Primary practice location

1200 Pleasant St
Des Moines, IA 50309-1406

Mailing address

1200 Pleasant St
Des Moines, IA 50309-1406
Phone (515) 241-6611

Other identifiers 1

IdentifierTypeStateIssuer
1003824822MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170210000526 IA Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 3476736000 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036096723ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ottumwa Health Group LLC CurrentSince Apr 15, 2017 Accepting new patients
Ottumwa Health Group LLC CurrentSince Apr 15, 2017 Accepting new patients

Locations

1001 Pennsylvania Ave
Ottumwa, IA 52501
Phone (641) 472-4111

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1003824822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 PLEASANT ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091406",
            "telephone_number": "515-241-6611",
            "fax_number": "515-241-6635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 PLEASANT ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091406",
            "telephone_number": "515-241-6611",
            "fax_number": "515-241-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNEILL",
        "first_name": "CATHERINE",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036096723",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "MD-42833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003824822",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.