Inner Health Services. Inc

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

INNER HEALTH SERVICES. INC

Practice address

4685 Merle Hay Rd Ste 108
Des Moines, IA 50322-1982

Phone

(515) 201-9953

Fax

(515) 251-4876

NPI assigned

Dec 16, 2018

Organization subpart

No

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

Authorized official

Name

Patricia Petersen, LISWNPI 1356343834

Title

Owner

Phone

(515) 201-9953

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Inner Health Services Former legal business name

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Practitioners 1

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

• Patricia Jean Petersen, LISW

  • Clinical Social Worker
  • Des Moines, IA
  • NPI 1356343834
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1104397223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4685 MERLE HAY RD STE 108",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503221982",
            "telephone_number": "515-201-9953",
            "fax_number": "515-251-4876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4685 MERLE HAY RD STE 108",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503221982",
            "telephone_number": "515-201-9953",
            "fax_number": "515-251-4876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER HEALTH SERVICES. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-16",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-201-9953",
        "authorized_official_credential": "LISW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356343834",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Inner Health Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Adult Mental Health Clinic/Center in Des Moines, IA
• Providers in Des Moines, IA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.