Townline Medical Clinic LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A92500 Issued in IA

Legal business name

TOWNLINE MEDICAL CLINIC LLC

Doing business as

d/b/a Family Health Clinic

Practice address

1332 E Main St
Lamoni, IA 50140-6311

Phone

(641) 784-7526

Fax

(641) 784-7526

NPI assigned

Jan 29, 2014

Last updated

Jun 16, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Crystal Jean Johnson, NP-BC.

Title

Owner/Sole Member

Phone

(515) 423-4685

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• d/b/a Family Health Clinic Doing business as

Locations

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

{
    "created_epoch": "1390953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434412800000",
    "number": "1811310733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1332 E MAIN ST",
            "city": "LAMONI",
            "state": "IA",
            "postal_code": "501406311",
            "telephone_number": "641-784-7526",
            "fax_number": "641-784-7527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1332 E MAIN ST",
            "city": "LAMONI",
            "state": "IA",
            "postal_code": "501406311",
            "telephone_number": "641-784-7526",
            "fax_number": "641-784-7526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWNLINE MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-29",
        "last_updated": "2015-06-16",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER/SOLE MEMBER",
        "authorized_official_telephone_number": "515-423-4685",
        "authorized_official_credential": "NP-BC."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A92500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1811310733",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811310733",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "d/b/a Family Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Leah A Olson, LMSW
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• Jessica Wallace

• Family Nurse Practitioner in Lamoni, IA
• Providers in Lamoni, IA by specialty
• Family Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; 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.