Active NPI
Carrie Janeczko, AUD
- Audiologist
- Clive, IA
National Provider Identifier
1619988581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 0586
- Practice address
- 1601 NW 114TH St
Suite 230
Clive, IA 50325-7007 - Phone
- (515) 222-7761
- Fax
- (515) 222-7926
- NPI assigned
- Aug 10, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 0586 | IA | Primary |
Addresses
Primary practice location
1601 NW 114TH St
Suite 230
Clive, IA 50325-7007
Mailing address
1055 6TH Ave
Suite 200
Des Moines, IA 50314-2607
Phone (515) 643-8672
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00586 | IA | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinics, Inc. | Past | Accepting new patients | |
| Mercy Clinics Inc | Past | Accepting new patients |
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.
-
dba MercyOne Des Moines OB Hospitalists
- Obstetrics & Gynecology Physician
- Des Moines, IA
- NPI 1508741505
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619988581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 6TH AVE",
"address_2": "SUITE 200",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503142607",
"telephone_number": "515-643-8672",
"fax_number": "515-643-2784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 NW 114TH ST",
"address_2": "SUITE 230",
"city": "CLIVE",
"state": "IA",
"postal_code": "503257007",
"telephone_number": "515-222-7761",
"fax_number": "515-222-7926"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JANECZKO",
"first_name": "CARRIE",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "IA",
"license": "0586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clive, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.