Active NPI
Jan M Foote, ARNP
- Pediatric Nurse Practitioner
- Des Moines, IA
National Provider Identifier
1740272822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- C063378
- Practice address
- 1215 Pleasant Street Suite 300
Blank Children's Pediatric Clinic - Endocrinology
Des Moines, IA 50309-1406 - Phone
- (515) 241-6500
- Fax
- (515) 241-8911
- NPI assigned
- Aug 16, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | C063378 | IA | Primary |
Addresses
Primary practice location
1215 Pleasant Street Suite 300
Blank Children's Pediatric Clinic - Endocrinology
Des Moines, IA 50309-1406
Mailing address
1200 Pleasant Street
Blank Administration
Des Moines, IA 50309-1416
Phone (515) 241-5926
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 175150054 | Other | MEDICARE | |
| 1740272822 | Medicaid | IA |
Other names 1
- Jan M Williams
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C063378 | IA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boone County Hospital | Past | Accepting new patients |
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.
-
- Critical Access Hospital
- Boone, IA
- NPI 1467434225
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434499200000",
"number": "1740272822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 PLEASANT STREET",
"address_2": "BLANK ADMINISTRATION",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503091416",
"telephone_number": "515-241-5926",
"fax_number": "515-241-5127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1215 PLEASANT STREET SUITE 300",
"address_2": "BLANK CHILDREN'S PEDIATRIC CLINIC - ENDOCRINOLOGY",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503091406",
"telephone_number": "515-241-6500",
"fax_number": "515-241-8911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOOTE",
"first_name": "JAN",
"middle_name": "M",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-16",
"last_updated": "2015-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "IA",
"license": "C063378",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "175150054",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1740272822",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JAN",
"last_name": "WILLIAMS",
"middle_name": "M",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.