Organization Active NPI

Elim DPC PLLC

  • Primary Care Clinic/Center
  • Indianola, IA
National Provider Identifier
1134076797
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
ELIM DPC PLLC
Practice address
909 E 2ND Ave Ste G
Indianola, IA 50125-2892
Phone
(515) 316-4128
NPI assigned
Mar 12, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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

Authorized official

Name
Jessica Devault, ARNPNPI 1306218565
Title
Owner
Phone
(515) 316-4128

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

909 E 2ND Ave Ste G
Indianola, IA 50125-2892

Mailing address

112 S 19TH CT
Indianola, IA 50125-4725
Phone (515) 316-4128

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
16D2343982Elim DPC909 E 2ND Ave Ste G, Indianola, IA 50125Certificate of waiverMay 13, 2028

National Provider Directory

National Provider Directory

Locations

909 E 2nd Ave
Ste G
Indianola, IA 50125
Phone (515) 316-4128

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1773273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773273600000",
    "number": "1134076797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 S 19TH CT",
            "city": "INDIANOLA",
            "state": "IA",
            "postal_code": "501254725",
            "telephone_number": "515-316-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 E 2ND AVE STE G",
            "city": "INDIANOLA",
            "state": "IA",
            "postal_code": "501252892",
            "telephone_number": "515-316-4128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIM DPC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-12",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A",
        "authorized_official_last_name": "DEVAULT",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-316-4128",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianola, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.