Individual provider Active NPI

Heidi Marie Hofbauer, CADC

  • Addiction (Substance Use Disorder) Counselor
  • Fort Dodge, IA
National Provider Identifier
1760855647
Registry record updated Nov 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
14097 Issued in IA
Practice address
1506 31St Ave N
Fort Dodge, IA 50501-7274
Phone
(515) 576-7261
Fax
(515) 955-7652
NPI assigned
Nov 2, 2015
Last updated
Nov 2, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 14097 IA Primary

Addresses

Primary practice location

1506 31St Ave N
Fort Dodge, IA 50501-7274

Mailing address

1506 31St Ave N
Fort Dodge, IA 50501-7274
Phone (515) 576-7261

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Undefined Non-Physician Type (Specify)
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

211 Ave M W
Fort Dodge, IA 50501-5789

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14097IAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Richmond Center PastSince Sep 26, 2011 Accepting new patients
United Community Services, Inc. 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1446422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446422400000",
    "number": "1760855647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 31ST AVE N",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505017274",
            "telephone_number": "515-576-7261",
            "fax_number": "515-955-7652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 31ST AVE N",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505017274",
            "telephone_number": "515-576-7261",
            "fax_number": "515-955-7652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFBAUER",
        "first_name": "HEIDI",
        "middle_name": "MARIE",
        "credential": "CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-02",
        "last_updated": "2015-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IA",
            "license": "14097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Dodge, IA

Sources for this page

Verify at the official NPI Registry.