Individual provider Active NPI

Noelle C Mundt, NP

  • Nurse Practitioner
  • Des Moines, IA
National Provider Identifier
1598726572
Registry record updated Aug 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A090681 Issued in IA
Practice address
840 E University Ave
Des Moines, IA 50316-2304
Phone
(515) 265-4211
Fax
(515) 309-5993
NPI assigned
Mar 30, 2006
Last updated
Aug 29, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2011

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 A090681 IA Primary

Addresses

Primary practice location

840 E University Ave
Des Moines, IA 50316-2304

Mailing address

8101 Birchwood CT
Suite S
Johnston, IA 50131-2930
Phone (515) 471-9720

Other identifiers 1

IdentifierTypeStateIssuer
0481176MedicaidIA

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
I20061016000014 IA Practitioner - Nurse Practitioner 8426054404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iowa Digestive Disease Center PCGroup PAC ID 4183522188, 24 clinicians

Practice addresses (Care Compare)

1378 NW 124TH St
Suite 200
Clive, IA 50325-8151
Phone (515) 288-6097

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A090681IAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Digestive Disease Center P.C. CurrentSince Dec 1, 2016 Accepting new patients
Boone County Hospital Past Accepting new patients

Locations

1378 NW 124th St
Ste 200
Clive, IA 50325
Phone (515) 288-6097

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314576000000",
    "number": "1598726572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 BIRCHWOOD CT",
            "address_2": "SUITE S",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312930",
            "telephone_number": "515-471-9720",
            "fax_number": "515-471-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 E UNIVERSITY AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503162304",
            "telephone_number": "515-265-4211",
            "fax_number": "515-309-5993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNDT",
        "first_name": "NOELLE",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-30",
        "last_updated": "2011-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A090681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0481176",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.