Individual provider Active NPI

Breanne Vogel

  • Family Nurse Practitioner
  • West Burlington, IA
National Provider Identifier
1679920045
Registry record updated Jul 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A119646 Issued in IA
Practice address
1225 South Gear Avenue, Suite 159
Great River Family Practice Clinic
West Burlington, IA 52655
Phone
(319) 754-4242
NPI assigned
May 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Nurse Practitioner 363LF0000X A119646 IA Primary

Addresses

Primary practice location

1225 South Gear Avenue, Suite 159
Great River Family Practice Clinic
West Burlington, IA 52655

Mailing address

1225 South Gear Avenue, Suite 159
Great River Family Practice Clinic
West Burlington, IA 52655

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
I20160804000896 IA Practitioner - Nurse Practitioner 0446544043 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Iowa Regional Medical Center IncGroup PAC ID 3870496417, 259 clinicians

Practice addresses (Care Compare)

1221 S Gear Ave
West Burlignton, IA 52655-1679
Phone (319) 768-1000

1225 S Gear Ave
West Burlington, IA 52655-1686

1321 S Gear
West Burlington, IA 52655-1604
Phone (319) 768-1000

Hospital & facility affiliations

  • Southeast Iowa Regional Medical Center Hospital, West Burlington, IA, CCN 160057
  • Henry County Health Center Hospital, Mount Pleasant, IA, CCN 161356

Merit-based Incentive Payment System (MIPS)

Final score
77.06 of 100Reported as group
Quality
64.36
Promoting interoperability
81
Improvement activities
40
Cost
75.01

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A119646IAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Iowa Regional Medical Center, Inc. CurrentSince Jul 1, 2021 Accepting new patients

Locations

1221 S Gear Ave
West Burlington, IA 52655
Phone (319) 768-3622

1225 S Gear Ave
Ste 159
West Burlington, IA 52655
Phone (319) 752-4553

1201 W Agency Rd
West Burlington, IA 52655
Phone (319) 394-3991

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.

Hospital & facility affiliations 2

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": "1463356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469491200000",
    "number": "1679920045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 SOUTH GEAR AVENUE, SUITE 159",
            "address_2": "GREAT RIVER FAMILY PRACTICE CLINIC",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "52655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 SOUTH GEAR AVENUE, SUITE 159",
            "address_2": "GREAT RIVER FAMILY PRACTICE CLINIC",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "52655",
            "telephone_number": "319-754-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOGEL",
        "first_name": "BREANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-16",
        "last_updated": "2016-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A119646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Burlington, IA

Sources for this page

Verify at the official NPI Registry.