Maquoketa Family Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MAQUOKETA FAMILY CLINIC

Practice address

206 N Arcade St
Maquoketa, IA 52060-2022

Phone

(563) 652-6711

Fax

(563) 652-6715

NPI assigned

Oct 17, 2005

Organization subpart

No

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

Authorized official

Name

Sarah Taylor

Title

Office Manager

Phone

(563) 652-6711

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jerald W Bybee, MD

  • Family Medicine Physician
  • Maquoketa, IA
  • NPI 1659360816
  Medicare reassignment Care Compare group NPD
• Vicki Hansen

  • Family Nurse Practitioner
  • Maquoketa, IA
  • NPI 1124560206
  Medicare reassignment Care Compare group NPD
• Bradley B Waller, MD

  • Family Medicine Physician
  • Maquoketa, IA
  • NPI 1609433796
  Medicare reassignment Care Compare group NPD
• Roger R Waller, MD

  • Family Medicine Physician
  • Maquoketa, IA
  • NPI 1750370011
  Medicare reassignment Care Compare group NPD
• Elizabeth A Gudgel, ARNP

  • Family Nurse Practitioner
  • Clive, IA
  • NPI 1710211594
  Medicare reassignment NPD
• Ann E Patterson, ARNP

  • Family Nurse Practitioner
  • Osceola, IA
  • NPI 1053544585

  Family Medicine

  Medicare reassignment NPD
• Alyssa Lakin, PA C

  • Family Medicine Physician
  • Maquoketa, IA
  • NPI 1629415922
  Medicare reassignment

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662076800000",
    "number": "1407845175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 N ARCADE ST",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520602022",
            "telephone_number": "563-652-6711",
            "fax_number": "563-652-6715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 N ARCADE ST",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520602022",
            "telephone_number": "563-652-6711",
            "fax_number": "563-652-6715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAQUOKETA FAMILY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-17",
        "last_updated": "2022-09-02",
        "certification_date": "2022-08-08",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "563-652-6711"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659360816",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750370011",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Limke, M.S. CCC-SLP
• Jody L Livesay, ARNP
• Bobbie Lona Mallari, ARNP AGPCNP
• Maquoketa Care Center, Inc (Maquoketa Care Center)
• Maquoketa Community School District
• Maquoketa Kidney Center, LLC
• Maquoketa Opco LLC (Maquoketa Care Center)
• Maquoketa Pharmacy Inc (M & M Care)
• Maquoketa Pharmacy Inc (Osterhaus Pharmacy)
• Marcia Gansen Martin

• Family Medicine Physician in Maquoketa, IA
• Providers in Maquoketa, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.