Gabrielle Eileen Iversen, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

2501 W 22ND St
Sioux Falls, SD 57105-1305

Phone

(605) 336-3230

NPI assigned

Sep 14, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Gabrielle Hogancamp Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505347200000",
    "number": "1275052953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 N CAREER AVE APT 270",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571071376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 W 22ND ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051305",
            "telephone_number": "605-336-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVERSEN",
        "first_name": "GABRIELLE",
        "middle_name": "EILEEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-14",
        "last_updated": "2017-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GABRIELLE",
            "last_name": "HOGANCAMP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kris Michael Isakson, D.C.
• Isd National Clinic LLC
• Lenn Island
• Mackenzie Island, RBT
• Vicki L Isler, EDD BCBA-D LBA
• Bradley Eugene Iverson, M.D.
• Brian Dale Iverson, MS, PT
• Iwe Inc.
• Stasia Ellen Iwuc, CPO
• Chinedu Izuchi, CNP

• Medical Physician Assistant in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Medical Physician Assistant in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2017; 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.