Midwest Ketafusion LLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

MIDWEST KETAFUSION LLC

Practice address

1700 S 1St Ave Ste 25a
Iowa City, IA 52240-6036

Phone

(319) 849-8114

Fax

(319) 333-0624

NPI assigned

Nov 4, 2020

Organization subpart

No

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

Authorized official

Name

Charlie Hong, CRNA, ARNP

Title

Nurse Anesthetist

Phone

(319) 331-4391

Specialties & licenses 9

Addresses

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

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    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682380800000",
    "number": "1831790104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 S 1ST AVE STE 25A",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522406036",
            "telephone_number": "319-849-8114",
            "fax_number": "319-333-0624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S 1ST AVE STE 25A",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522406036",
            "telephone_number": "319-849-8114",
            "fax_number": "319-333-0624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST KETAFUSION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-04",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A",
        "authorized_official_last_name": "HONG",
        "authorized_official_first_name": "CHARLIE",
        "authorized_official_title_or_position": "NURSE ANESTHETIST",
        "authorized_official_telephone_number": "319-331-4391",
        "authorized_official_credential": "CRNA, ARNP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0807X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
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            "state": null,
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        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
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        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": null,
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        },
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
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            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
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        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Jo Leichty Michels, DNP-CPNP-PC
• Tricia E Michna, ARNP, MA
• Steven Richard Mickelsen, MD
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• Stephanie Miecznikowski, RDH
• Ashleigh Miele, DPT
• Shannon Louise Miers
• Marissa Mifflin, MD
• Charles Dylan Miks, MD

• Anesthesiology Physician in Iowa City, IA
• Providers in Iowa City, IA by specialty
• Anesthesiology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; 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.