Individual provider Active NPI

Ann Marie Luke, RN PHN FNP

  • Nurse Practitioner
  • Le Mars, IA
National Provider Identifier
1396889895
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A176073 Issued in IA
Practice address
1 Blue Bunny Dr SW
Le Mars, IA 51031-2207
Phone
(712) 966-7200
Fax
(855) 547-6073
NPI assigned
Feb 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 374579 CA
Family Nurse Practitioner 363LF0000X 11617 CA
Nurse Practitioner 363L00000X A176073 IA Primary

Addresses

Primary practice location

1 Blue Bunny Dr SW
Le Mars, IA 51031-2207

Mailing address

1721 Rebecca St
Sioux City, IA 51103-2433
Phone (707) 391-6903

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20100429000410 CA Practitioner - Nurse Practitioner 2961539663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.41 of 100Reported as group
Quality
86.32
Promoting interoperability
95
Improvement activities
40
Cost
66.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11617CAMDAddiction (Substance Use Disorder) Counselor
374579CAMDCommunity Health Registered Nurse
A176073IAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Consolidated Tribal Health Project, Inc. CurrentSince Feb 24, 2017 Accepting new patients
Healthstat Health Center Wells Corporate Past Accepting new patients

Locations

6991 N State St
Redwood Vly, CA 95470
Phone (707) 467-5620

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15156/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1396889895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 REBECCA ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511032433",
            "telephone_number": "707-391-6903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BLUE BUNNY DR SW",
            "city": "LE MARS",
            "state": "IA",
            "postal_code": "510312207",
            "telephone_number": "712-966-7200",
            "fax_number": "855-547-6073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKE",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RN  PHN FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CA",
            "license": "374579",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "11617",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A176073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Le Mars, IA

Sources for this page

Verify at the official NPI Registry.