Athena Integrated Care PLLC
Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Council Bluffs, IA
NPI 1508582289 · NPPES record last updated Oct 14, 2022
Key facts
- NPI
- 1508582289
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- Legal business name
- ATHENA INTEGRATED CARE PLLC
- Practice address
- 300 W Broadway Ste 240
Council Bluffs, IA 51503-9028 - Phone
- (712) 266-3577
- Fax
- (712) 336-8541
- NPI assigned
- Oct 14, 2022
- Organization subpart
- No
Authorized official
- Name
- Mrs. Athena Clare Fertig, MSN,APRN,PMHNP,FNP
- Title
- President/Treasurer
- Phone
- (712) 266-3577
Practitioners 13
-
Athena C Fertig, APRN,PMHNP-BC,NP-C
-
Jeannie Lynn Franklin, PMHNP
-
Rachel Marie Ruskamp, APRN
-
Kelsey Burr, PMHNP
-
Sonya Fittje, MA, LMHP
-
Brittany Marshall, PSY.D
-
Trisha McGann, LIMHP
-
Michelle Ann Adams, LIMHP, LADC
-
Kimberly Linn Becker, LIMHP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IA, NE
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221101001702 | IA | Part B Supplier - Clinic/Group Practice | 3779950902 |
Receives reassigned benefits from 3 practitioners Practice locations: Altoona, IA; Council Bluffs, IA |
| O20251218000619 | NE | Part B Supplier - Clinic/Group Practice | 3779950902 |
Receives reassigned benefits from 4 practitioners Practice locations: Omaha, NE; Papillion, NE |
National Provider Directory
Locations
700 1st Ave S
Altoona, IA 50009
Phone (515) 443-3992
1237 Golden Gate Dr
Papillion, NE 68046
Phone (402) 590-2947
Interoperability endpoints
- info@athenaibh.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | |||
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | Yes |
Addresses
Primary practice location
300 W Broadway Ste 240
Council Bluffs, IA 51503-9028
Mailing address
300 W Broadway Ste 240
Council Bluffs, IA 51503-9028
Phone (712) 266-3577
Other names
- Athena Integrated Behavioral Health
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | info@athenaIBH.com | Direct |
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All providers in Council Bluffs, IA · Psychiatric/Mental Health Nurse Practitioner in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.