Active NPI
Women'S Wellness Center, PC
- Nurse Practitioner
- Dubuque, IA
National Provider Identifier
1245298934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- Legal business name
- WOMEN'S WELLNESS CENTER, PC
- Practice address
- 777 Mazzuchelli PL
Dubuque, IA 52001-7359 - Phone
- (563) 588-0011
- Fax
- (563) 588-0595
- NPI assigned
- May 2, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kelly S McMahon
- Title
- Administrative Assistan
- Phone
- (319) 233-3044
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | Primary |
Addresses
Primary practice location
777 Mazzuchelli PL
Dubuque, IA 52001-7359
Mailing address
PO Box 2400
Waterloo, IA 50704-2400
Phone (319) 233-3044
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38510 | Other | IA | BLUE SHIELD |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146528000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1245298934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2400",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507042400",
"telephone_number": "319-233-3044",
"fax_number": "319-233-0722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 MAZZUCHELLI PL",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520017359",
"telephone_number": "563-588-0011",
"fax_number": "563-588-0595"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WOMEN'S WELLNESS CENTER, PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-02",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "MCMAHON",
"authorized_official_first_name": "KELLY",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "ADMINISTRATIVE ASSISTAN",
"authorized_official_telephone_number": "319-233-3044"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "38510",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dubuque, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.