Athena C Fertig, APRN,PMHNP-BC,NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

A149479 Issued in IA

Practice address

300 W Broadway Ste 240
Council Bluffs, IA 51503-9028

Phone

(712) 266-3577

Fax

(712) 336-8541

NPI assigned

Jul 21, 2010

Last updated

Sep 19, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NE, IA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Creighton University School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Athena Integrated Care PLLCGroup PAC ID 3779950902, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Athena Integrated Care PLLC

  dba Athena Integrated Behavioral Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Council Bluffs, IA
  • NPI 1508582289

  Family, NE

  Medicare reassignment Care Compare group NPD Authorized official
• Unmc Physicians

  • Multi-Specialty Clinic/Center
  • Omaha, NE
  • NPI 1417912114
  Medicare reassignment NPD
• New Century Physicians of Iowa PC

  • Emergency Medicine Physician
  • Council Bluffs, IA
  • NPI 1548269301
  NPD
• New Century Physicians of Nebraska LLC

  • Emergency Medicine Physician
  • Omaha, NE
  • NPI 1013916600
  NPD
• New Century Physicians of Nebraska LLC

  • Emergency Medicine Physician
  • Papillion, NE
  • NPI 1063411833
  NPD
• Three Rivers Public Health Department

  dba Three Rivers District Health Dept

  • Public Health or Welfare Agency
  • Fremont, NE
  • NPI 1710041124
  NPD
• Alegent Creighton Clinic

  dba CHI Health Clinic

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1548287907
  NPD (past)
• Primus Health Care PC

  • Family Medicine Physician
  • Lincoln, NE
  • NPI 1508171612
  NPD (past)

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

{
    "created_epoch": "1279670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1093028805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W BROADWAY STE 240",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515039028",
            "telephone_number": "712-266-3577",
            "fax_number": "712-336-8541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W BROADWAY STE 240",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515039028",
            "telephone_number": "712-266-3577",
            "fax_number": "712-336-8541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2440 O St",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "NE",
            "postal_code": "685101125",
            "country_code": "US",
            "telephone_number": "402-475-7666",
            "fax_number": "402-476-9623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERTIG",
        "first_name": "ATHENA",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "APRN,PMHNP-BC,NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-21",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "111149",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A149479",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A149479",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "111149",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G171495",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NE",
            "license": "111149",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025024400",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NE",
            "identifier": "47279",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025024300",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NE (PLH)",
            "identifier": "48515",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Lynn Fauzae
• Joy Lynn Fazheimbaugh
• Erin Feind
• Casey A Ferguson, MS, LMHP, CPC
• Norman E Ferrer, M.D.
• Maddison Paige Fidone, PA
• Kelsey Fillman, MD, MPH
• Breanna M Finley, APRN-NP
• Kristine Marie Fischer
• Alan Fisher, M.D.

• Nurse Practitioner in Council Bluffs, IA
• Providers in Council Bluffs, IA by specialty
• Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.