NPIMap

Organization Active NPI

Hy-Vee Health PC

  • Registered Dietitian
  • Liberty, MO
National Provider Identifier
1669248506
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
HY-VEE HEALTH PC
Practice address
109 N Blue Jay Dr
Liberty, MO 64068-1906
Phone
(515) 225-2930
NPI assigned
Dec 1, 2023
Last updated
Dec 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Authorized official

Name
Daniel S FickNPI 1457347049
Title
Cmo
Phone
(515) 225-2930

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

109 N Blue Jay Dr
Liberty, MO 64068-1906

Mailing address

5820 Westown Pkwy
West Des Moines, IA 50266-8223

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240517003010 MO Part B Supplier - Clinic/Group Practice 1254701618 Receives reassigned benefits from 9 practitioners
1 other NPI on this enrollment
Practice locations: Blue Springs, MO; Springfield, MO; Saint Joseph, MO; Lees Summit, MO; Kansas City, MO; Columbia, MO; Liberty, MO

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Hy-Vee Health PC14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1701388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701388800000",
    "number": "1669248506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5820 WESTOWN PKWY",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502668223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N BLUE JAY DR",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640681906",
            "telephone_number": "515-225-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HY-VEE HEALTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-01",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A",
        "authorized_official_last_name": "FICK",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "515-225-2930"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; 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.