Organization Active NPI

Women'S Wellness Center, PC

  • Nurse Practitioner
  • Dubuque, IA
National Provider Identifier
1245298934
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
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

Updated by the provider on Aug 22, 2020

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)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
38510OtherIABLUE SHIELD

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.