NPIMap

Organization Active NPI

University of Northern Iowa

Doing business as University of Northern Iowa Student Health Clinic

  • Family Medicine Physician
  • Cedar Falls, IA
National Provider Identifier
1497822795
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
UNIVERSITY OF NORTHERN IOWA
Doing business as
University of Northern Iowa Student Health Clinic
Practice address
1227 W 27TH St
Cedar Falls, IA 50614-0221
Phone
(319) 273-2009
Fax
(319) 273-7030
NPI assigned
Nov 29, 2006
Last updated
Dec 1, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

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

Authorized official

Name
Connie L Potter
Title
Administrative Specialist
Phone
(319) 273-7736

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1227 W 27TH St
Cedar Falls, IA 50614-0221

Mailing address

1227 W 27TH St
Cedar Falls, IA 50614-0221
Phone (319) 273-2009

Other names 1

  • University of Northern Iowa Student Health Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161205001766 IA Part B Supplier - Clinic/Group Practice 9234419425 Receives reassigned benefits from 1 practitioner
Practice locations: Cedar Falls, IA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D0708533Unversity of Northern Iowa Student Health Clinic1227 W 27TH St SHC 0221, Cedar Falls, IA 50614AccreditationDec 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
University of Northern Iowa4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1227 W 27th St
Cedar Falls, IA 50614
Phone (319) 273-2009

1227 W 27th St
#221
Cedar Falls, IA 50614
Phone (319) 273-2154

1227 W 27th St
#C
Cedar Falls, IA 50614
Phone (319) 273-2009

Student Health Ctr
Cedar Falls, IA 50614
Phone (319) 273-2154

Student Health Ctr
Bldg 0221
Cedar Falls, IA 50614

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480550400000",
    "number": "1497822795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1227 W 27TH ST",
            "city": "CEDAR FALLS",
            "state": "IA",
            "postal_code": "506140221",
            "telephone_number": "319-273-2009",
            "fax_number": "319-273-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 W 27TH ST",
            "city": "CEDAR FALLS",
            "state": "IA",
            "postal_code": "506140221",
            "telephone_number": "319-273-2009",
            "fax_number": "319-273-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF NORTHERN IOWA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2016-12-01",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATIVE SPECIALIST",
        "authorized_official_telephone_number": "319-273-7736"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University of Northern Iowa Student Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cedar Falls, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; 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.