Individual provider Active NPI

Mollie Elizabeth Siebels, PHARMD

  • Pharmacist
  • Cedar Rapids, IA
National Provider Identifier
1639449713
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
20214 Issued in IA
Practice address
617 8TH Ave SE
Cedar Rapids, IA 52401-2117
Phone
(319) 364-4181
Fax
(319) 363-5448
NPI assigned
Jan 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 20214 IA Primary

Addresses

Primary practice location

617 8TH Ave SE
Cedar Rapids, IA 52401-2117

Mailing address

525 Brandilynn Blvd
Cedar Falls, IA 50613-7415
Phone (319) 277-7793

Other practice location 1

525 Brandilynn Blvd
Cedar Falls, IA 50613-7415
Phone (319) 277-7793

Other identifiers 1

IdentifierTypeStateIssuer
137463MedicaidIA

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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
20214IAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Reutzel Pharmacy Inc PastSince Aug 11, 2024 Accepting new patients

Organizations & group practices 1

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": "1325808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1639449713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 BRANDILYNN BLVD",
            "city": "CEDAR FALLS",
            "state": "IA",
            "postal_code": "506137415",
            "telephone_number": "319-277-7793",
            "fax_number": "319-277-6665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 8TH AVE SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524012117",
            "telephone_number": "319-364-4181",
            "fax_number": "319-363-5448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 Brandilynn Blvd",
            "address_purpose": "LOCATION",
            "city": "Cedar Falls",
            "state": "IA",
            "postal_code": "506137415",
            "country_code": "US",
            "telephone_number": "319-277-7793",
            "fax_number": "319-277-6665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIEBELS",
        "first_name": "MOLLIE",
        "middle_name": "ELIZABETH",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-06",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "20214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137463",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; 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.