Passion Health Care Provider LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

PASSION HEALTH CARE PROVIDER LLC

Practice address

208 NW Driftwood CT
Ankeny, IA 50023-6817

Phone

(515) 525-5369

NPI assigned

Jun 24, 2025

Organization subpart

No

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

Authorized official

Name

Derick MbachamNPI 1891637914

Title

Executive Director

Phone

(515) 525-5369

Specialties & licenses 1

Addresses

Other names 1

• Passion Health Care Provider LLC Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Derick N Mbacham, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Ankeny, IA
  • NPI 1891637914
  NPD Authorized official

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

{
    "created_epoch": "1750723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750723200000",
    "number": "1649168337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 NW DRIFTWOOD CT",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500236817",
            "telephone_number": "515-525-5369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 NW DRIFTWOOD CT",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500236817",
            "telephone_number": "515-525-5369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSION HEALTH CARE PROVIDER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-24",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A",
        "authorized_official_last_name": "MBACHAM",
        "authorized_official_first_name": "DERICK",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "515-525-5369"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Passion Health Care Provider LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jacob Michael Parker
• Laura Parkinson, L.AC
• Anna Grace Parr, DPT
• Becky L Parrish, ARNP
• Emily Parrott
• Megan Leslee Patrick, DNP, ARNP
• Ava Patterson
• Julianne Marie Patterson, ARNP, FNP-BC, FNP-C
• Jean Paul, D.O.
• Laura Lynne Pavlik, PHARMD

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Ankeny, IA
• Providers in Ankeny, IA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.