Individual provider Active NPI

Ann Glick

  • Psychiatric/Mental Health Nurse Practitioner
  • Iowa City, IA
National Provider Identifier
1609283274
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
G117446 Issued in IA
Practice address
673 Westbury Dr
#201
Iowa City, IA 52245-2730
Phone
(319) 356-6352
NPI assigned
Jul 16, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 117446 IA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X G117446 IA Primary

Addresses

Primary practice location

673 Westbury Dr
#201
Iowa City, IA 52245-2730

Mailing address

673 Westbury Dr
#201
Iowa City, IA 52245-2730
Phone (319) 356-6352

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Oct 14, 2021 through Oct 14, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
117446IAMDRegistered Nurse
G117446IAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Associates of Iowa, PC Past Accepting new patients
Psychiatric Associates of Iowa, PC Past Accepting new patients
Todd Verhoef, MD P.C. Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1609283274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "673 WESTBURY DR",
            "address_2": "#201",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522452730",
            "telephone_number": "319-356-6352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "673 WESTBURY DR",
            "address_2": "#201",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522452730",
            "telephone_number": "319-356-6352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICK",
        "first_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-16",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IA",
            "license": "117446",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G117446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.