Active NPI
Gloria R West, RN
- Registered Nurse
- Fort Dodge, IA
National Provider Identifier
1508946906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 043633
- Practice address
- 720 Kenyon Rd
North Central Iowa MHC Dba Berryhill Center for Mental
Fort Dodge, IA 50501-5759 - Phone
- (515) 955-7171
- Fax
- (515) 573-7898
- NPI assigned
- Oct 17, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 043633 | IA | Primary |
Addresses
Primary practice location
720 Kenyon Rd
North Central Iowa MHC Dba Berryhill Center for Mental
Fort Dodge, IA 50501-5759
Mailing address
720 Kenyon Rd
North Central Iowa MHC Dba Berryhill Center for Mental
Fort Dodge, IA 50501-5759
Phone (515) 955-7171
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07466 | Other | IA | WELLMARK BCBS |
| 0159608 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 043633 | IA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Central Iowa Mental Health Center, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Fort Dodge, IA
- NPI 1871910588
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234310400000",
"number": "1508946906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 KENYON RD",
"address_2": "NORTH CENTRAL IOWA MHC DBA BERRYHILL CENTER FOR MENTAL",
"city": "FORT DODGE",
"state": "IA",
"postal_code": "505015759",
"telephone_number": "515-955-7171",
"fax_number": "515-573-7898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 KENYON RD",
"address_2": "NORTH CENTRAL IOWA MHC DBA BERRYHILL CENTER FOR MENTAL",
"city": "FORT DODGE",
"state": "IA",
"postal_code": "505015759",
"telephone_number": "515-955-7171",
"fax_number": "515-573-7898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEST",
"first_name": "GLORIA",
"middle_name": "R",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-17",
"last_updated": "2009-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IA",
"license": "043633",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BCBS",
"identifier": "07466",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0159608",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Dodge, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.