NPIMap

Community Health and Immunization Services, LLC

Organization Active NPI Community Health Worker · Bettendorf, IA

NPI 1295147759 · NPPES record last updated Oct 8, 2021

Key facts

NPI
1295147759
Entity type
Organization (NPI type 2)
Primary specialty
Community Health Worker 172V00000X
Legal business name
COMMUNITY HEALTH AND IMMUNIZATION SERVICES, LLC
Practice address
2435 Kimberly Rd Ste 140
Bettendorf, IA 52722-3509
Phone
(515) 393-3409
NPI assigned
Jun 2, 2014
Organization subpart
No

Authorized official

Name
Rebekah Suazo
Title
Medical Billing Supervisor
Phone
(480) 646-9099

Corporate family (same tax ID) 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

National Provider Directory

Tax ID family
Community Health and Immunization Services LLC (32 organizations share this tax ID)

Locations

2435 Kimberly Rd
Ste 140
Bettendorf, IA 52722
Phone (515) 393-3409

950 Office Park Rd
Ste 215B
West Des Moines, IA 50265

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker
Group: 193400000X SINGLE SPECIALTY GROUP		 172V00000X Yes

Addresses

Primary practice location

2435 Kimberly Rd Ste 140
Bettendorf, IA 52722-3509

Mailing address

668 N 44TH St Ste 100W
Phoenix, AZ 85008-6507
Phone (877) 358-8648

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 8, 2021.

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633651200000",
    "number": "1295147759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "668 N 44TH ST STE 100W",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850086507",
            "telephone_number": "877-358-8648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 KIMBERLY RD STE 140",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527223509",
            "telephone_number": "515-393-3409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH AND IMMUNIZATION SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-02",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A",
        "authorized_official_last_name": "SUAZO",
        "authorized_official_first_name": "REBEKAH",
        "authorized_official_title_or_position": "MEDICAL BILLING SUPERVISOR",
        "authorized_official_telephone_number": "480-646-9099"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bettendorf, IA

All providers in Bettendorf, IA · Community Health Worker in Iowa

Sources for this page

Verify at the official NPI Registry.