Organization Active NPI

New Leaf Wellness

  • General Practice Physician
  • Clive, IA
National Provider Identifier
1235475088
Registry record updated Dec 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
01554 Issued in IA
Legal business name
NEW LEAF WELLNESS
Practice address
12129 University Ave Ste 1500
Clive, IA 50325-8287
Phone
(515) 657-6210
Fax
(515) 657-6208
NPI assigned
Dec 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2012

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

Authorized official

Name
Art Mattson
Title
Management
Phone
(931) 252-2932

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 01554 IA Primary

Addresses

Primary practice location

12129 University Ave Ste 1500
Clive, IA 50325-8287

Mailing address

12129 University Ave Ste 1500
Clive, IA 50325-8287
Phone (515) 657-6210

National Provider Directory

National Provider Directory

Locations

12129 University Ave
Ste 1500
Clive, IA 50325
Phone (515) 267-1800

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": "1356480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356480000000",
    "number": "1235475088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12129 UNIVERSITY AVE STE 1500",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258287",
            "telephone_number": "515-657-6210",
            "fax_number": "515-657-6208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12129 UNIVERSITY AVE STE 1500",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258287",
            "telephone_number": "515-657-6210",
            "fax_number": "515-657-6208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LEAF WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-26",
        "last_updated": "2012-12-26",
        "status": "A",
        "authorized_official_last_name": "MATTSON",
        "authorized_official_first_name": "ART",
        "authorized_official_title_or_position": "MANAGEMENT",
        "authorized_official_telephone_number": "931-252-2932"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "IA",
            "license": "01554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2012; 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.