Kara A Widhalm, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

112274 Issued in IA

Practice address

800 Mercy Dr
Council Bluffs, IA 51503-3128

Phone

(712) 328-5230

NPI assigned

Nov 4, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NE, IA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vascular and Interventional Radiology of SiouxlandGroup PAC ID 7113330663, 24 clinicians

Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI Health Mercy Council Bluffs Hospital, Council Bluffs, IA, CCN 160028
• CHI Health Bergan Mercy Hospital, Omaha, NE, CCN 280060
• CHI Health Immanuel Hospital, Omaha, NE, CCN 280081

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Alegent Creighton Clinic

  • Family Medicine Physician
  • Council Bluffs, IA
  • NPI 1598811069

  IA, Physician Assistant

  Medicare reassignment Care Compare group NPD
• Vascular & Interventional Radiology of Siouxland

  • Vascular Surgery Physician
  • Dakota Dunes, SD
  • NPI 1225636129

  IA, NE

  Medicare reassignment Care Compare group NPD
• Alegent Creighton Clinic

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1548287907

  NE

  Medicare reassignment NPD
• MD West One, PC

  • Neurological Surgery Physician
  • Omaha, NE
  • NPI 1588616767

  IA, NE, Physician Assistant

  Medicare reassignment NPD
• Sage Medical Prof LLC

  • Vascular Surgery Physician
  • Dakota Dunes, SD
  • NPI 1588156657

  NE

  Medicare reassignment NPD (past)
• Alegent Creighton Clinic

  • Internal Medicine Physician
  • Omaha, NE
  • NPI 1154680700
  NPD
• MD West One, PC

  • Durable Medical Equipment & Medical Supplies
  • Elkhorn, NE
  • NPI 1740933530
  NPD
• New Century Physicians of Nebraska LLC

  • Emergency Medicine Physician
  • Omaha, NE
  • NPI 1013916600
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Alegent Health Bergan Mercy Health System

  • General Acute Care Hospital
  • Council Bluffs, IA
  • NPI 1265517759

  Hospital

  Care Compare affiliation
• Alegent Health Bergan Mercy Health System

  • Psychiatric Hospital Unit
  • Omaha, NE
  • NPI 1396969499

  Hospital

  Care Compare affiliation
• Alegent Health Bergan Mercy Health System

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1508941097

  Hospital

  Care Compare affiliation
• Alegent Health Immanuel Medical Center

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1912085184

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1635984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1740945757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MERCY DR",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515033128",
            "telephone_number": "712-328-5230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MERCY DR",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515033128",
            "telephone_number": "712-328-5230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 N 192nd St",
            "address_purpose": "LOCATION",
            "city": "Elkhorn",
            "state": "NE",
            "postal_code": "680225363",
            "country_code": "US",
            "telephone_number": "402-390-4111",
            "fax_number": "402-390-4115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIDHALM",
        "first_name": "KARA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-04",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2681",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NE",
            "license": "2681",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "112274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William L Wettengel, RPH
• James Whalen, M.D.
• Angela Wheeler
• Andrea Celeste White, ARNP
• Michelle White
• David Frederick Widitz, MD
• Lindsie Wilde I, PHARMD
• Anna Theresa Wiley, MD
• Devon Wilhelm-McMullen, DNP
• Kent Willadsen, M.D.

• Physician Assistant in Council Bluffs, IA
• Providers in Council Bluffs, IA by specialty
• Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.