Individual provider Active NPI

Roseanne Hixenbaugh, ARNP

  • Nurse Practitioner
  • Des Moines, IA
National Provider Identifier
1811252448
Registry record updated Jul 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
061854 Issued in IA
Practice address
3600 30TH St
Des Moines, IA 50310-5753
Phone
(515) 699-5807
Fax
(515) 699-5779
NPI assigned
Jul 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 061854 IA Primary

Addresses

Primary practice location

3600 30TH St
Des Moines, IA 50310-5753

Mailing address

924 52ND CT
WDM, IA 50265-2715
Phone (515) 225-7765

Other identifiers 1

IdentifierTypeStateIssuer
363L00000XOtherIAVA

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

State licenses

LicenseStateTypeSpecialty
061854IAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341878400000",
    "number": "1811252448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 52ND CT",
            "city": "WDM",
            "state": "IA",
            "postal_code": "502652715",
            "telephone_number": "515-225-7765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 30TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503105753",
            "telephone_number": "515-699-5807",
            "fax_number": "515-699-5779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIXENBAUGH",
        "first_name": "ROSEANNE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-10",
        "last_updated": "2012-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "061854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA",
            "identifier": "363L00000X",
            "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 Jul 10, 2012; 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.