NPIMap

Organization Active NPI

Guided Ascent

  • Psychiatric/Mental Health Nurse Practitioner
  • Urbandale, IA
National Provider Identifier
1669223038
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
GUIDED ASCENT
Practice address
2400 82ND PL
Urbandale, IA 50322-4328
Phone
(515) 664-7386
NPI assigned
Apr 1, 2024
Last updated
Apr 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Authorized official

Name
Courtney Marie Fuller, RN
Title
Ceo
Phone
(515) 249-3338

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

2400 82ND PL
Urbandale, IA 50322-4328

Mailing address

809 Kingman Blvd
Madrid, IA 50156-1424
Phone (515) 664-7386

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240904001254 IA Part B Supplier - Clinic/Group Practice 3274073382 Receives reassigned benefits from 6 practitioners
Practice locations: Johnston, IA

National Provider Directory

National Provider Directory

Locations

2400 82nd Pl
Urbandale, IA 50322
Phone (515) 412-5112

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711929600000",
    "number": "1669223038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 KINGMAN BLVD",
            "city": "MADRID",
            "state": "IA",
            "postal_code": "501561424",
            "telephone_number": "515-664-7386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 82ND PL",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503224328",
            "telephone_number": "515-664-7386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUIDED ASCENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "515-249-3338",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbandale, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.