NPIMap

Organization Active NPI

Ottumwa Mental Wellness Center

  • Physician Assistant
  • Ottumwa, IA
National Provider Identifier
1235410697
Registry record updated Jul 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
OTTUMWA MENTAL WELLNESS CENTER
Practice address
801 N Quincy Ave
Ottumwa, IA 52501-3869
Phone
(641) 684-7744
Fax
(641) 684-7700
NPI assigned
Aug 30, 2011
Last updated
Jul 5, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2013

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

Authorized official

Name
Melissa N Gentry, P.A-CNPI 1538153846
Title
Owner
Phone
(641) 684-7744

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X IA Primary

Addresses

Primary practice location

801 N Quincy Ave
Ottumwa, IA 52501-3869

Mailing address

801 N Quincy Ave Ste 4
Ottumwa, IA 52501-3869
Phone (641) 684-7744

National Provider Directory

National Provider Directory

Locations

801 N Quincy Ave
Ottumwa, IA 52501
Phone (641) 682-8219

801 N Quincy Ave
Ste 4
Ottumwa, IA 52501
Phone (641) 684-7744

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372982400000",
    "number": "1235410697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 N QUINCY AVE STE 4",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525013869",
            "telephone_number": "641-684-7744",
            "fax_number": "641-684-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N QUINCY AVE",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525013869",
            "telephone_number": "641-684-7744",
            "fax_number": "641-684-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTTUMWA MENTAL WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-30",
        "last_updated": "2013-07-05",
        "status": "A",
        "authorized_official_last_name": "GENTRY",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "641-684-7744",
        "authorized_official_credential": "P.A-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottumwa, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2013; 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.