Individual provider Active NPI

Christine T Jensen, MD

  • Family Medicine Physician
  • Marshalltown, IA
National Provider Identifier
1720050297
Registry record updated Jul 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
33080 Issued in IA
Practice address
101 Iowa Ave W
Marshalltown, IA 50158
Phone
(641) 754-6700
Fax
(641) 753-1375
NPI assigned
Feb 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 33080 IA Primary

Addresses

Primary practice location

101 Iowa Ave W
Marshalltown, IA 50158

Mailing address

101 Iowa Ave W
Marshalltown, IA 50158-4768
Phone (641) 754-6700

Other practice location 1

519 F Avenue
Nevada Medical Clinic
Nevada, IA 50201
Phone (515) 382-5413

Other identifiers 6

IdentifierTypeStateIssuer
41013OtherIAWELLMARK BCBS
0634600MedicaidIA
3177113MedicaidIA
41001OtherIAWELLMARK BCBS
4177113MedicaidIA
41014OtherIAWELLMARK BCBS

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140930001595 IA Order and Referring Only - Family PracticePractitioner - Family Practice 7214073659

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33080IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Story County Hospital Past Accepting new patients
Floyd County Memorial Hospital Commission Family Medicine Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531785600000",
    "number": "1720050297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 IOWA AVE W",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "501584768",
            "telephone_number": "641-754-6700",
            "fax_number": "647-753-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 IOWA AVE W",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "50158",
            "telephone_number": "641-754-6700",
            "fax_number": "641-753-1375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "519 F Avenue",
            "address_2": "Nevada Medical Clinic",
            "address_purpose": "LOCATION",
            "city": "Nevada",
            "state": "IA",
            "postal_code": "50201",
            "country_code": "US",
            "telephone_number": "515-382-5413",
            "fax_number": "515-382-7173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "CHRISTINE",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2018-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "33080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "41013",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0634600",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3177113",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "41001",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4177113",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "41014",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshalltown, IA

Sources for this page

Verify at the official NPI Registry.