Active NPI
Leeann Hoodjer
- Psychiatric/Mental Health Nurse Practitioner
- Waverly, IA
National Provider Identifier
1104073428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- G110925
- Practice address
- Waverly Health Center
312 9TH Street SW
Waverly, IA 50677 - Phone
- (319) 352-4120
- NPI assigned
- Aug 19, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A-110925 | IA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | G110925 | IA | Primary |
Addresses
Primary practice location
Waverly Health Center
312 9TH Street SW
Waverly, IA 50677
Mailing address
312 9TH St SW
Waverly, IA 50677-2999
Phone (319) 352-4120
Other practice location 1
Healthy Minds, PLLC
118 1st St. SW
Waverly, IA 50677
Phone (319) 404-2956
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0076372 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A-110925 | IA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674086400000",
"number": "1104073428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "312 9TH ST SW",
"city": "WAVERLY",
"state": "IA",
"postal_code": "506772999",
"telephone_number": "319-352-4120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "WAVERLY HEALTH CENTER",
"address_2": "312 9TH STREET SW",
"city": "WAVERLY",
"state": "IA",
"postal_code": "50677",
"telephone_number": "319-352-4120"
}
],
"practiceLocations": [
{
"address_1": "Healthy Minds, PLLC",
"address_2": "118 1st St. SW",
"address_purpose": "LOCATION",
"city": "Waverly",
"state": "IA",
"postal_code": "50677",
"country_code": "US",
"telephone_number": "319-404-2956",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOODJER",
"first_name": "LEEANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-19",
"last_updated": "2023-01-19",
"certification_date": "2023-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IA",
"license": "A-110925",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "IA",
"license": "G110925",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0076372",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waverly, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.