Heartland Integrative Psychiatric Services Co

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

G067317 Issued in IA

Legal business name

HEARTLAND INTEGRATIVE PSYCHIATRIC SERVICES CO

Practice address

2587 130TH St
Traer, IA 50675-9550

Phone

(319) 404-0461

NPI assigned

Dec 26, 2014

Last updated

Dec 26, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Joellen C Kubik, ARNP

Title

President

Phone

(319) 404-0461

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1419552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419552000000",
    "number": "1467840470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2587 130TH ST",
            "city": "TRAER",
            "state": "IA",
            "postal_code": "506759550",
            "telephone_number": "319-404-0461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2587 130TH ST",
            "city": "TRAER",
            "state": "IA",
            "postal_code": "506759550",
            "telephone_number": "319-404-0461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND INTEGRATIVE PSYCHIATRIC SERVICES CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-26",
        "last_updated": "2014-12-26",
        "status": "A",
        "authorized_official_last_name": "KUBIK",
        "authorized_official_first_name": "JOELLEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "319-404-0461",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G067317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City of Traer (Traer Ambulance Service)
• Dustin Michael Gaskin
• Shawn Michelle Grimm, M.A., CCC-SLP
• Shellina Marie Herink
• Kelly Mathews, OTR/L
• Phyllis A McKee, RPH
• North Tama County Community School District
• Nudak Ventures LLC (NuCara Pharmacy #12)

• Psychiatric/Mental Health Nurse Practitioner in Traer, IA
• Providers in Traer, IA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.