Andrea G Dettmann-Spurgeon, CPNP, ARNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

C-106794 Issued in IA

Practice address

2555 Berkshire Pkwy Ste a
Clive, IA 50325-4646

Phone

(515) 987-0051

Fax

(515) 987-0054

NPI assigned

Dec 12, 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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: adettmannspurgeon1027353@direct.unitypoint.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.

• Iowa Physicians Clinic Medical Foundation

  • General Practice Physician
  • West Des Moines, IA
  • NPI 1366425274

  IA

  Medicare reassignment NPD
• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• Waggoner Pediatrics, PLC

  • Pediatrics Physician
  • Clive, IA
  • NPI 1225572548
  NPD (past)

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482451200000",
    "number": "1346301892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 BERKSHIRE PKWY STE A",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503254646",
            "telephone_number": "515-987-0051",
            "fax_number": "515-987-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 BERKSHIRE PKWY STE A",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503254646",
            "telephone_number": "515-987-0051",
            "fax_number": "515-987-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETTMANN-SPURGEON",
        "first_name": "ANDREA",
        "middle_name": "G",
        "name_prefix": "Ms.",
        "credential": "CPNP, ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2016-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IA",
            "license": "C-106794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Denhartog, O.D.
• Christine Nicole Dennison, OTR/L, OTD
• Dermatology and Dermatologic Surgery Center, PC
• Emily Ann Dermody, ARNP
• Des Moines OB GYN Specialists PC
• Emily Dewall
• Kiley Elizabeth Dewhurst, BCBA
• Hugh Charles Dick, M.D.
• Kirsten Dickinson, MD
• Emmaleigh Katelynn Aviana Dieguez, RBT

• All providers in Clive, IA
• Pediatric Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2016; 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.