Jacquelyn Johnston, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

002403 Issued in IA

Practice address

306 N 3Rd Ave E
Newton, IA 50208-3249

Phone

(641) 792-4012

Fax

(641) 791-0697

NPI assigned

Jun 12, 2013

Last updated

Aug 5, 2022By the provider in NPPES

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

• Jacquelyn Stortenbecker Former name

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Capstone Behavioral Healthcare IncGroup PAC ID 0648169573, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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

• Capstone Behavioral Healthcare, Inc

  • Community/Behavioral Health Agency
  • Newton, IA
  • NPI 1174598908
  Medicare reassignment Care Compare group
• Boone County Hospital

  • Critical Access Hospital
  • Boone, IA
  • NPI 1467434225
  NPD (past)
• Poweshiek County Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Grinnell, IA
  • NPI 1528166360
  NPD (past)

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1316385271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 N 3RD AVE E",
            "city": "NEWTON",
            "state": "IA",
            "postal_code": "502083249",
            "telephone_number": "641-792-4012",
            "fax_number": "641-791-0697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 N 3RD AVE E",
            "city": "NEWTON",
            "state": "IA",
            "postal_code": "502083249",
            "telephone_number": "641-792-4012",
            "fax_number": "641-791-0697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "JACQUELYN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-12",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "002403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELYN",
            "last_name": "STORTENBECKER",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jasper County Health Department (Jasper County)
• Jasper County Health Ventures LLC (Newton Express Care Clinic)
• Jennifer L Kramer PLLC (Connect Counseling PLLC)
• Jet Dental of Iowa, PLLC
• Amanda Johnson, PHD
• Duane M Jolivette, MD
• Tiffany Nicole Jones
• Neeraja Kakade, M.D.
• Amber Karsten, PT
• Jayden Kauk, PTA

• Physician Assistant in Newton, IA
• Providers in Newton, IA by specialty
• Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.