The Childserve Clinic Inc

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

THE CHILDSERVE CLINIC INC

Practice address

5406 Merle Hay Rd
Johnston, IA 50131-1209

Phone

(515) 727-8750

Fax

(515) 727-8757

NPI assigned

Jan 12, 2010

Organization subpart

No

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

Authorized official

Name

Jennifer Pavlovec

Title

Director of Finance

Phone

(515) 727-1463

Specialties & licenses 15

Addresses

Other names 2

• ChildServe Clinics Doing business as
• ChildServe Therapy Clinics Other name

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Tax ID family

Childserve Audiology4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Childserve Therapy Inc.

  • Rehabilitation Clinic/Center
  • Johnston, IA
  • NPI 1073731378
  NPD tax ID
• Childserve Therapy Inc.

  • Rehabilitation Clinic/Center
  • Johnston, IA
  • NPI 1982822284
  NPD tax ID
• Childserve Therapy, Inc.

  • Physical Therapist
  • Johnston, IA
  • NPI 1679614754
  NPD tax ID

Locations

Practitioners 143

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

• Leah Jeanine Brandon, DO

  • Pediatrics Physician
  • Johnston, IA
  • NPI 1417214321
  Medicare reassignment Care Compare group NPD
• Randalyn Parker, LMSW

  • Clinical Social Worker
  • Des Moines, IA
  • NPI 1265849673
  Medicare reassignment Care Compare group NPD
• Lane Moser, M.D., M.P.H.

  • Pediatric Hospice and Palliative Medicine Physician
  • Johnston, IA
  • NPI 1508247990

  Pediatrics

  Medicare reassignment Care Compare group NPD (past)
• Maria Anne Johnson, ARNP

  • Pediatric Nurse Practitioner
  • Johnston, IA
  • NPI 1417624966
  Medicare reassignment NPD
• Fredrick T Klingbeil, MD

  • Pediatric Rehabilitation Medicine Physician
  • Johnston, IA
  • NPI 1346291184
  Medicare reassignment NPD
• Hannah Marie Slaughter, APRN

  • Pediatric Nurse Practitioner
  • Johnston, IA
  • NPI 1508288275
  Medicare reassignment NPD
• Chastity Marree Butts, RN, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Johnston, IA
  • NPI 1922810357
  Medicare reassignment NPD (past)
• Elaina Mae Abrams, PT, DPT

  • Physical Therapist
  • Coralville, IA
  • NPI 1235836164
  NPD (past)
• Julia Anderson, OTR/L

  • Occupational Therapist
  • Johnston, IA
  • NPI 1760756118
  NPD (past)
• Zoe N Angus, MA, CF-SLP

  • Speech-Language Pathologist
  • Coralville, IA
  • NPI 1356927966
  NPD (past)
• Kori R Assman Nolting

  • Speech-Language Pathologist
  • Cedar Rapids, IA
  • NPI 1003551136
  NPD (past)
• Heather Nicole Baird, CF-SLP

  • Speech-Language Pathologist
  • Coralville, IA
  • NPI 1932940780

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1263254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602115200000",
    "number": "1033449145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 707",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501310707",
            "telephone_number": "515-727-8750",
            "fax_number": "515-727-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5406 MERLE HAY RD",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501311209",
            "telephone_number": "515-727-8750",
            "fax_number": "515-727-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHILDSERVE CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-12",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A",
        "authorized_official_last_name": "PAVLOVEC",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "515-727-1463"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ChildServe Clinics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ChildServe Therapy Clinics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Alexis V Taylor, PA
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• Abby Tekippe
• Miranda Rebecca Temple, ARNP
• Hannah Ileen Zimmerman Thakur, MA, CCC-SLP
• The Saint Dymphna Center for Counseling and Family Therapy
• Theramind
• Mallory Margaret Thielen
• Nichole Thomson, LMSW
• Thrive Spectrum LLC

• Pediatrics Physician in Johnston, IA
• Providers in Johnston, IA by specialty
• Pediatrics Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; 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.