Individual provider Active NPI

Carrie Marcoux, ARNP

  • Nurse Practitioner
  • Waterloo, IA
National Provider Identifier
1548924186
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A166257 Issued in IA
Practice address
419 E Donald St
Waterloo, IA 50703-1500
Phone
(319) 236-1911
NPI assigned
Oct 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A166257 IA Primary

Addresses

Primary practice location

419 E Donald St
Waterloo, IA 50703-1500

Mailing address

PO Box 2758
Waterloo, IA 50704-2758

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address csmedstad556672@direct.unitypoint.org Direct Allen Memorial Hospital Corporation

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211118001020 IA Practitioner - Nurse Practitioner 2163811837 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4480 Utica Ridge Rd
Bettendorf, IA 52722-1644

4480 Utica Ridge Rd
Suite 160
Bettendorf, IA 52722-1637
Phone (563) 742-5950

5100 Prairie Pkwy
Cedar Falls, IA 50613-8155

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Allen Memorial Hospital Corporation Current Accepting new patients
Iowa Physicians Clinic Medical Foundation CurrentSince Jul 28, 2025 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Allen Memorial Hospital Corporation Nurse Practitioner CurrentSince Jun 8, 2022 Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

1600 1st St E
Independence, IA 50644
Phone (319) 332-0999

909 W 1st St
Sumner, IA 50674
Phone (563) 578-3275

419 E Donald St
Waterloo, IA 50703
Phone (319) 888-7604

1753 W Ridgeway Ave
Ste 107
Waterloo, IA 50701
Phone (319) 833-5907

1825 Logan Ave
Waterloo, IA 50703
Phone (319) 235-3886

Interoperability endpoints

  • Direct secure messaging: csmedstad556672@direct.unitypoint.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1635465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1548924186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2758",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507042758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 E DONALD ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507031500",
            "telephone_number": "319-236-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCOUX",
        "first_name": "CARRIE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-29",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A166257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csmedstad556672@direct.unitypoint.org",
            "affiliation": "Y",
            "endpointDescription": "UnityPoint",
            "affiliationName": "Allen Memorial Hospital Corporation",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1825 Logan Ave",
            "city": "Waterloo",
            "state": "IA",
            "country_code": "US",
            "postal_code": "507031916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.