Jamie Renea Pugh, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

P46589 Issued in IA

Practice address

1750 W Broadway
Council Bluffs, IA 51501-3814

Phone

(712) 215-6588

NPI assigned

Nov 1, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jamie Renea Phillips Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• CRC Recovery, Inc.

  • Methadone Clinic
  • Council Bluffs, IA
  • NPI 1326689076
  NPD

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

{
    "created_epoch": "1667260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1124735915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 W BROADWAY",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515013814",
            "telephone_number": "712-215-6588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 W BROADWAY",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515013814",
            "telephone_number": "712-215-6588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGH",
        "first_name": "JAMIE",
        "middle_name": "RENEA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-01",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IA",
            "license": "P46589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "PHILLIPS",
            "middle_name": "RENEA",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Progressive Therapy Associates, LLC
• Promising Tomorrows Care Solutions Ia LLC
• Promising Tomorrows Care Solutions Ia LLC
• Joplin Pruitt
• Psychiatric Services of Western Iowa Inc
• Pulmonary Infectious Disease Associates PC
• Joseph Quattrocchi Jr., D.D.S.
• Christy Michelle Quillen, ARNP
• Laura Quinnette, PA-C
• Diana Jeries Rabadi-Marar, M.D.

• Licensed Practical Nurse in Council Bluffs, IA
• Providers in Council Bluffs, IA by specialty
• Licensed Practical Nurse in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.