NPIMap

Individual provider Active NPI

Laci Ann Dykstra, ARNP

  • Nurse Practitioner
  • Pella, IA
National Provider Identifier
1699176297
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A112498 Issued in IA
Practice address
615 Washington St
Pella, IA 50219-1538
Phone
(641) 628-2222
Fax
(641) 628-2915
NPI assigned
Sep 15, 2014
Last updated
Aug 12, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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 A112498 IA Primary

Addresses

Primary practice location

615 Washington St
Pella, IA 50219-1538

Mailing address

1202 W Howard St
Knoxville, IA 50138-3103
Phone (641) 842-2151

Other names 1

  • Miss Laci Sneller Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address LaciDykstra@khc.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141117000920 IA Practitioner - Nurse Practitioner 3870715303 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knoxville Community Hospital IncGroup PAC ID 6608787056, shared by 3 NPIs, 34 clinicians

Practice addresses (Care Compare)

1202 W Howard St
Knoxville, IA 50138-3103
Phone (641) 828-7211

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A112498IAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Knoxville Community Hospital Inc Nurse Practitioner CurrentSince Oct 4, 2014 Accepting new patients
Knoxville Community Hospital Inc Current Accepting new patients
Knoxville Community Hospital Inc Current Accepting new patients

Locations

1002 S Lincoln St
Knoxville, IA 50138
Phone (641) 842-1464

1202 W Howard St
Knoxville, IA 50138
Phone (641) 828-7144

615 Washington St
Pella, IA 50219
Phone (641) 628-2222

Interoperability endpoints

  • Direct secure messaging: lacidykstra@khc.cernerdirect.com

Organizations & group practices 3

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 7

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": "1410739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1699176297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 W HOWARD ST",
            "city": "KNOXVILLE",
            "state": "IA",
            "postal_code": "501383103",
            "telephone_number": "641-842-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 WASHINGTON ST",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502191538",
            "telephone_number": "641-628-2222",
            "fax_number": "641-628-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYKSTRA",
        "first_name": "LACI",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-15",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A112498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "LaciDykstra@khc.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "knoxville hospital and clinics direct email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "615 Washington St",
            "city": "Pella",
            "state": "IA",
            "country_code": "US",
            "postal_code": "502191538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LACI",
            "last_name": "SNELLER",
            "prefix": "MISS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pella, IA

Sources for this page

Verify at the official NPI Registry.