Individual provider Active NPI

Nicole Marie Myers, ARNP (FNP-BC)

  • Women's Health Nurse Practitioner
  • Cedar Rapids, IA
National Provider Identifier
1285078196
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
122399 Issued in IA
Practice address
855 A Avenue NE
Cedar Rapids, IA 52402
Phone
(319) 391-5501
Fax
(319) 743-2610
NPI assigned
Apr 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 122399 IA Primary

Addresses

Primary practice location

855 A Avenue NE
Cedar Rapids, IA 52402

Mailing address

855 A Avenue NE
PO Box 3080
Cedar Rapids, IA 52406-3080
Phone (319) 391-5501

Other identifiers 1

IdentifierTypeStateIssuer
0297192MedicaidIA

Other names 1

  • Nicole Marie Henderson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130814000083 IA Practitioner - Nurse Practitioner 5395987721 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
OB-GYN Associates PCGroup PAC ID 9830089929, 18 clinicians

Practice addresses (Care Compare)

855 A Ave NE
Suite 200
Cedar Rapids, IA 52402-5064
Phone (319) 391-5501

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
122399IAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1285078196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 A AVENUE NE",
            "address_2": "PO BOX 3080",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524063080",
            "telephone_number": "319-391-5501",
            "fax_number": "319-743-2610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 A AVENUE NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "52402",
            "telephone_number": "319-391-5501",
            "fax_number": "319-743-2610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "ARNP (FNP-BC)",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-22",
        "last_updated": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IA",
            "license": "122399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0297192",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "HENDERSON",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.