NPIMap

Organization Active NPI

Woodward Youth Corporation

  • Community/Behavioral Health Agency
  • Des Moines, IA
National Provider Identifier
1740695170
Registry record updated Jun 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
317887 Issued in IA
Legal business name
WOODWARD YOUTH CORPORATION
Practice address
611 5TH Ave
Ground Level
Des Moines, IA 50309-1603
Phone
(515) 274-9607
Fax
(515) 274-9614
NPI assigned
Jun 24, 2014
Last updated
Jun 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2014

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

Authorized official

Name
Mr. Shawn Hollenkamp
Title
Executive Director
Phone
(515) 274-9607

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 317887 IA Primary

Addresses

Primary practice location

611 5TH Ave
Ground Level
Des Moines, IA 50309-1603

Mailing address

611 5TH Ave
Ground Level
Des Moines, IA 50309-1603
Phone (515) 274-9607

Other identifiers 1

IdentifierTypeStateIssuer
1140012MedicaidIA

National Provider Directory

National Provider Directory
Tax ID family
Woodward Academy4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403568000000",
    "number": "1740695170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 5TH AVE",
            "address_2": "GROUND LEVEL",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091603",
            "telephone_number": "515-274-9607",
            "fax_number": "515-274-9614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 5TH AVE",
            "address_2": "GROUND LEVEL",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091603",
            "telephone_number": "515-274-9607",
            "fax_number": "515-274-9614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODWARD YOUTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-24",
        "last_updated": "2014-06-24",
        "status": "A",
        "authorized_official_last_name": "HOLLENKAMP",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "515-274-9607",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IA",
            "license": "317887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1140012",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.