Bridget Wickstrom, PA-C

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

107523 Issued in IA

Practice address

200 Essie Davidson Dr
Clarinda, IA 51632

Phone

(712) 542-2176

NPI assigned

Mar 29, 2021

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

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

University of Nebraska College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clarinda Regional Health CenterGroup PAC ID 4587573993, 46 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Clarinda Regional Health Center Hospital, Clarinda, IA, CCN 161352
• Clarinda Regional Health Center Nursing home, CCN 16Z352

Merit-based Incentive Payment System (MIPS)

Final score

67.97 of 100Reported as apm

Quality

34.29

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Clarinda Regional Health Center

  • Family Medicine Physician
  • Clarinda, IA
  • NPI 1629196241
  Medicare reassignment Care Compare group NPD
• Clarinda Regional Health Center

  • Critical Access Hospital
  • Clarinda, IA
  • NPI 1366486946
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Clarinda Regional Health Center

  • Medicare Defined Swing Bed Hospital Unit
  • Clarinda, IA
  • NPI 1255489647

  Nursing home

  Care Compare affiliation
• Clarinda Regional Health Center

  • Critical Access Hospital
  • Clarinda, IA
  • NPI 1366486946
  Care Compare affiliation

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1336727858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 ESSIE DAVIDSON DR",
            "city": "CLARINDA",
            "state": "IA",
            "postal_code": "51632",
            "telephone_number": "712-542-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ESSIE DAVIDSON DR",
            "city": "CLARINDA",
            "state": "IA",
            "postal_code": "51632",
            "telephone_number": "712-542-2176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKSTROM",
        "first_name": "BRIDGET",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "107523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Renee Wallick, LMSW
• Ashleigh Nicole Waltz
• Waubonsie Mental Health Center Inc
• Julie Weiss, PT
• Wendy McCoy PC
• Amy E Wilmes, ARNP
• Jessica Woldruff, TLMHC
• Emily Wood, DPT
• Mandy Lynn Woods, ARNP
• Cortney Young

• Emergency Medicine Physician in Clarinda, IA
• Providers in Clarinda, IA by specialty
• Emergency Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.