NPIMap

Organization Active NPI

State University of Iowa

  • Ambulatory Women's Health Care Registered Nurse
  • Council Bluffs, IA
National Provider Identifier
1609915628
Registry record updated Mar 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Women's Health Care Registered NurseTaxonomy code 163WW0101X
Legal business name
STATE UNIVERSITY OF IOWA
Practice address
3501 Harry Langdon Blvd Ste 1450
Child Health Specialty Clinics
Council Bluffs, IA 51503-7837
Phone
(712) 309-0041
Fax
(712) 309-0044
NPI assigned
Feb 6, 2007
Last updated
Mar 1, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2012

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

Authorized official

Name
Philip E Roudabush
Title
Director, Patient Financial Service
Phone
(319) 384-2334

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Women's Health Care Registered Nurse 163WW0101X NU Primary

Addresses

Primary practice location

3501 Harry Langdon Blvd Ste 1450
Child Health Specialty Clinics
Council Bluffs, IA 51503-7837

Mailing address

100 Hawkins Drive
Child Health Specialty Clinics
Iowa City, IA 52242
Phone (319) 354-6674

Other identifiers 1

IdentifierTypeStateIssuer
0736264MedicaidIA

Other names 1

  • CHSC Maternal Health Other name

National Provider Directory

National Provider Directory
Tax ID family
Univ of Ia Hosps Clins57 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

3501 Harry Langdon Blvd
Ste 1450
Council Bluffs, IA 51503
Phone (712) 309-0041

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330560000000",
    "number": "1609915628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HAWKINS DRIVE",
            "address_2": "CHILD HEALTH SPECIALTY CLINICS",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "52242",
            "telephone_number": "319-354-6674",
            "fax_number": "319-356-3715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 HARRY LANGDON BLVD STE 1450",
            "address_2": "CHILD HEALTH SPECIALTY CLINICS",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515037837",
            "telephone_number": "712-309-0041",
            "fax_number": "712-309-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE UNIVERSITY OF IOWA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2012-03-01",
        "status": "A",
        "authorized_official_last_name": "ROUDABUSH",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR, PATIENT FINANCIAL SERVICE",
        "authorized_official_telephone_number": "319-384-2334"
    },
    "taxonomies": [
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0736264",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHSC Maternal Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.