Organization Active NPI

Pottawattamie County

  • Public Health or Welfare Agency
  • Council Bluffs, IA
National Provider Identifier
1053881102
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
POTTAWATTAMIE COUNTY
Practice address
515 5TH Ave
Council Bluffs, IA 51503-0903
Phone
(712) 242-1131
Fax
(712) 242-1162
NPI assigned
Dec 3, 2018
Last updated
Mar 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Authorized official

Name
Maria Sieck
Title
Public Health Administrator
Phone
(712) 242-1155

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X NU Primary

Addresses

Primary practice location

515 5TH Ave
Council Bluffs, IA 51503-0903

Mailing address

227 S 6TH St
Council Bluffs, IA 51501-4269
Phone (712) 328-5792

Other identifiers 1

IdentifierTypeStateIssuer
0082503MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190116001175 IA Part B Supplier - Clinic/Group Practice 9436495231 Receives reassigned benefits from 1 practitioner
Practice locations: Council Bluffs, IA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D1069218Pottawattamie County Public Health515 5TH Ave, Council Bluffs, IA 51503Provider-performed microscopyApr 14, 2028

National Provider Directory

National Provider Directory
Tax ID family
Pottawattamie County2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

515 5th Ave
Council Bluffs, IA 51503
Phone (712) 242-1131

600 S 4th St
Council Bluffs, IA 51503
Phone (712) 242-1131

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1543795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741219200000",
    "number": "1053881102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 S 6TH ST",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515014269",
            "telephone_number": "712-328-5792",
            "fax_number": "712-328-4731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 5TH AVE",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515030903",
            "telephone_number": "712-242-1131",
            "fax_number": "712-242-1162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTTAWATTAMIE COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-03",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A",
        "authorized_official_last_name": "SIECK",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "PUBLIC HEALTH ADMINISTRATOR",
        "authorized_official_telephone_number": "712-242-1155"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0082503",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.