Individual provider Active NPI

Kayln Marie Boge-Kleiss, ARNP

  • Nurse Practitioner
  • Waterloo, IA
National Provider Identifier
1649930066
Registry record updated Dec 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F06212251 Issued in IA
Practice address
1825 Logan Ave
Waterloo, IA 50703-1916
Phone
(641) 330-8862
NPI assigned
Dec 27, 2021
Last updated
Dec 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F06212251 IA Primary

Addresses

Primary practice location

1825 Logan Ave
Waterloo, IA 50703-1916

Mailing address

1825 Logan Ave
Waterloo, IA 50703-1916
Phone (641) 330-8862

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220208001358 IA Practitioner - Nurse Practitioner 6204229628 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sumner Community ClubGroup PAC ID 5890607691, shared by 3 NPIs, 11 clinicians

Practice addresses (Care Compare)

909 W 1St St
Sumner, IA 50674-1203
Phone (563) 578-3275

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F06212251IAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Iowa Physicians Clinic Medical Foundation CurrentSince Feb 14, 2022 Accepting new patients
Sumner Community Club Current Accepting new patients
Sumner Community Club Nurse Practitioner CurrentSince Jan 6, 2025 Accepting new patients
Sumner Community Club Nurse Practitioner CurrentSince Jan 6, 2025 Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

909 W 1st St
Sumner, IA 50674
Phone (563) 578-3275

1825 Logan Ave
Waterloo, IA 50703
Phone (319) 235-3886

6010 Mills Civic Pkwy
Ste 100
West Des Moines, IA 50266
Phone (515) 221-7800

Interoperability endpoints

  • Direct secure messaging: kbogekleiss109097@direct.unitypoint.org

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1640563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1649930066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 LOGAN AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507031916",
            "telephone_number": "641-330-8862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 LOGAN AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507031916",
            "telephone_number": "641-330-8862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGE-KLEISS",
        "first_name": "KAYLN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-27",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "F06212251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.