Joanna Kay Oberbroeckling

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

J048928 Issued in IA

Practice address

2979 Victoria St
Bettendorf, IA 52722-2784

Phone

(563) 332-8528

NPI assigned

Aug 30, 2006

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144339003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2319 E 32ND ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2979 VICTORIA ST",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527222784",
            "telephone_number": "563-332-8528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERBROECKLING",
        "first_name": "JOANNA",
        "middle_name": "KAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IA",
            "license": "J048928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0474809",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Nicole Norris, AGACNP
• Zachary Stewart Norton, PMHNP
• Dawn M Nowell, FNP
• Nutrition Up LLC
• Martin R O'Malley, M.D.
• Darin D Oberhart, LPN, LMT
• Mary Carol Oberhart, APRN
• Occupational Health Centers of the Southwest P.a.
• Jaroslava Odvarko, DC
• Kyongsock Oh, DC

• Gerontology Nurse Practitioner in Bettendorf, IA
• Providers in Bettendorf, IA by specialty
• Gerontology Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.