Jenni M. Haan, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1220 Issued in NE

Practice address

933 E Pierce St
Council Bluffs, IA 51503-4626

Phone

(712) 396-4360

Fax

(712) 396-7069

NPI assigned

May 4, 2006

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 identifiers 3

Other names 1

• Jenni M. Leohr Former name

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jenni.haan@direct.nmhs.org

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.

• Physicians Clinic Inc

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1821049156
  NPD

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1316995343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 E PIERCE ST",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515034626",
            "telephone_number": "712-396-4360",
            "fax_number": "712-396-7069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8419 S 73rd Plz Ste 101",
            "address_purpose": "LOCATION",
            "city": "Papillion",
            "state": "NE",
            "postal_code": "680461507",
            "country_code": "US",
            "telephone_number": "402-991-9060",
            "fax_number": "402-991-9052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAAN",
        "first_name": "JENNI",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "1220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100263273-00",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316995343",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470687317-16",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNI",
            "last_name": "LEOHR",
            "middle_name": "M.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alexa Nicole Grzywa, PA-C
• Gerardo Guerrero-Segura
• Patricia Guerrero
• Garima Gupta
• Kami Lynn Guzman, M.S
• Miranda Mae Hadden
• Ahmed Gamal Abdellatif Hafez
• Lindsey Haffke, RD
• Hagen Chiropractic Inc
• Kimberly Hagner, ARNP

• Medical Physician Assistant in Council Bluffs, IA
• Providers in Council Bluffs, IA by specialty
• Medical Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; 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.

Verify at the official NPI Registry.