Active NPI
Joyce Vacek, PAC
- Physician Assistant
- Council Bluffs, IA
National Provider Identifier
1285791186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 702
- Practice address
- 2201 W Broadway Ste 9
Council Bluffs, IA 51501-3605 - Phone
- (712) 328-9100
- NPI assigned
- Jan 2, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 702 | IA | Primary |
Addresses
Primary practice location
2201 W Broadway Ste 9
Council Bluffs, IA 51501-3605
Mailing address
7261 Mercy Rd
Omaha, NE 68124-2311
Phone (402) 398-6255
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 702 | IA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576022400000",
"number": "1285791186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7261 MERCY RD",
"city": "OMAHA",
"state": "NE",
"postal_code": "681242311",
"telephone_number": "402-398-6255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2201 W BROADWAY STE 9",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515013605",
"telephone_number": "712-328-9100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VACEK",
"first_name": "JOYCE",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-02",
"last_updated": "2019-12-11",
"certification_date": "2019-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IA",
"license": "702",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Council Bluffs, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.