Active NPI
Paula K Forest, ARNP
- Gerontology Nurse Practitioner
- Iowa City, IA
National Provider Identifier
1194798488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- J050653
- Practice address
- 200 Hawkins Dr
Iowa City, IA 52242-1009 - Phone
- (319) 356-4241
- Fax
- (319) 356-3086
- NPI assigned
- Feb 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 050653 | IA | |
| Gerontology Nurse Practitioner | 363LG0600X | J050653 | IA | Primary |
Addresses
Primary practice location
200 Hawkins Dr
Iowa City, IA 52242-1009
Mailing address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-4241
Other practice location 1
105 E 9th St
Coralville, IA 52241-2209
Phone (319) 467-2000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0474890 | Medicaid | IA | |
| 46223 | Other | IA | WELLMARK BCBS |
Other names 1
- Paula K Willenborg
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 050653 | IA | MD | Nurse Practitioner |
| J050653 | IA | MD | Gerontology Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561680000000",
"number": "1194798488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 HAWKINS DR",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522421009",
"telephone_number": "319-356-4241",
"fax_number": "319-356-3086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 HAWKINS DR",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522421009",
"telephone_number": "319-356-4241",
"fax_number": "319-356-3086"
}
],
"practiceLocations": [
{
"address_1": "105 E 9th St",
"address_purpose": "LOCATION",
"city": "Coralville",
"state": "IA",
"postal_code": "522412209",
"country_code": "US",
"telephone_number": "319-467-2000",
"fax_number": "319-467-2410",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FOREST",
"first_name": "PAULA",
"middle_name": "K",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-08",
"last_updated": "2019-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IA",
"license": "050653",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "IA",
"license": "J050653",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0474890",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BCBS",
"identifier": "46223",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "PAULA",
"last_name": "WILLENBORG",
"middle_name": "K",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Iowa City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.