Active NPI
Olympia Niederecker
- Prosthetic/Orthotic Supplier
- Cedar Rapids, IA
National Provider Identifier
1750468930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- Practice address
- 1650 1St Ave NE
Cedar Rapids, IA 52402-5431 - Phone
- (319) 362-3937
- Fax
- (319) 362-2900
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | Primary |
Addresses
Primary practice location
1650 1St Ave NE
Cedar Rapids, IA 52402-5431
Mailing address
923 Harlocke St
Iowa City, IA 52246-5127
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0380170001 | Other | IA | DMERC |
| 13625 | Other | IA | BCBS |
| 0136259 | Medicaid | IA |
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750468930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "923 HARLOCKE ST",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522465127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 1ST AVE NE",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524025431",
"telephone_number": "319-362-3937",
"fax_number": "319-362-2900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIEDERECKER",
"first_name": "OLYMPIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMERC",
"identifier": "0380170001",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "13625",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0136259",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cedar Rapids, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.