Active NPI
John Fikkert
- Mental Health Counselor
- Pella, IA
National Provider Identifier
1831571892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 078220
- Practice address
- 2611 Washington St
Pella, IA 50219-7924 - Phone
- (641) 628-9599
- NPI assigned
- Jun 25, 2015
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 078220 | IA | Primary |
Addresses
Primary practice location
2611 Washington St
Pella, IA 50219-7924
Mailing address
2611 Washington St
Pella, IA 50219-7924
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 21, 2024 through Nov 21, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 078220 | IA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435190400000",
"number": "1831571892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2611 WASHINGTON ST",
"city": "PELLA",
"state": "IA",
"postal_code": "502197924"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2611 WASHINGTON ST",
"city": "PELLA",
"state": "IA",
"postal_code": "502197924",
"telephone_number": "641-628-9599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FIKKERT",
"first_name": "JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-25",
"last_updated": "2015-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": "078220",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pella, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.