Individual provider Active NPI

Jennifer Ruth Bissing Petts, D.O.

  • Allergy & Immunology Physician
  • West Des Moines, IA
National Provider Identifier
1144455502
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
DO-04284 Issued in IA
Practice address
5950 University Ave
Ste 265
West Des Moines, IA 50266
Phone
(515) 875-9450
Fax
(515) 875-9457
NPI assigned
May 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X DO-04284 IA Primary

Addresses

Primary practice location

5950 University Ave
Ste 265
West Des Moines, IA 50266

Mailing address

PO Box 424
Des Moines, IA 50302-0424
Phone (515) 875-9255

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jenniferpetts@tic.allscriptsdirect.net

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140707000394 IA Practitioner - Allergy/Immunology 9638309651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Iowa Clinic PCGroup PAC ID 4082513742, 307 clinicians

Practice addresses (Care Compare)

5950 University Ave
Suite 265
West Des Moines, IA 50266-8233
Phone (515) 875-9100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO-04284IAMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Iowa Clinic, PC CurrentSince Aug 18, 2014 Accepting new patients
The Iowa Clinic PC CurrentSince Aug 18, 2014 Accepting new patients

Locations

509 N Madison St
Bloomfield, IA 52537
Phone (641) 664-2145

1005 Pennsylvania Ave
Ste 102A
Ottumwa, IA 52501
Phone (641) 684-2589

5950 University Ave
Ste 175
West Des Moines, IA 50266
Phone (515) 875-9908

5950 University Ave
Ste 265
West Des Moines, IA 50266
Phone (515) 875-9450

5950 University Ave
Ste 275
West Des Moines, IA 50266
Phone (515) 875-9255

6800 Lake Dr
Ste 250
West Des Moines, IA 50266

7147 Vista Dr
Ste 150
West Des Moines, IA 50266
Phone (515) 875-9255

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1144455502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 424",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503020424",
            "telephone_number": "515-875-9255",
            "fax_number": "515-875-9223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5950 UNIVERSITY AVE",
            "address_2": "STE 265",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "50266",
            "telephone_number": "515-875-9450",
            "fax_number": "515-875-9457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTS",
        "first_name": "JENNIFER",
        "middle_name": "RUTH BISSING",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-28",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "IA",
            "license": "DO-04284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jenniferpetts@tic.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "5950 University Ave",
            "address_2": "Ste 265",
            "city": "West Des Moines",
            "state": "IA",
            "country_code": "US",
            "postal_code": "50266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

Verify at the official NPI Registry.