Active NPI
Rachelle L Gammon, DO
- Pediatrics Physician
- Windsor Heights, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 3803
- Practice address
- 974 73Rd St
Suite 30
Windsor Heights, IA 50312-1024 - Phone
- (515) 224-4993
- Fax
- (515) 224-1505
- NPI assigned
- Jun 18, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 3803 | IA | Primary |
Addresses
Primary practice location
974 73Rd St
Suite 30
Windsor Heights, IA 50312-1024
Mailing address
974 73Rd St
Suite 30
Windsor Heights, IA 50312-1024
Phone (515) 224-4993
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891990271 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070910001048 | IA | Practitioner - Pediatric Medicine | 7911090709 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3803 | IA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Luke'S Methodist Hospital | Current | Accepting new patients | |
| Iowa Physicians Clinic Medical Foundation | Pediatrics | Current | Accepting new patients |
| Boone County Hospital | Past | Accepting new patients |
Locations
909 SW Oralabor Rd
Ankeny, IA 50023
Phone (515) 963-4400
4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150
8101 Birchwood Ct
Unit R
Urbandale, IA 50131
Phone (515) 471-9363
6000 University Ave
Ste 100
West Des Moines, IA 50266
Phone (515) 241-2500
974 73rd St
Ste 30
West Des Moines, IA 50265
Phone (515) 224-4993
Interoperability endpoints
- rgammon9995@direct.unitypoint.org
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Physician
- West Des Moines, IA
- NPI 1366425274
IA, Pediatrics
-
- General Acute Care Hospital
- Cedar Rapids, IA
- NPI 1083708226
-
- Critical Access Hospital
- Boone, IA
- NPI 1467434225
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337644800000",
"number": "1891990271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "974 73RD ST",
"address_2": "SUITE 30",
"city": "WINDSOR HEIGHTS",
"state": "IA",
"postal_code": "503121024",
"telephone_number": "515-224-4993",
"fax_number": "515-224-1505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "974 73RD ST",
"address_2": "SUITE 30",
"city": "WINDSOR HEIGHTS",
"state": "IA",
"postal_code": "503121024",
"telephone_number": "515-224-4993",
"fax_number": "515-224-1505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAMMON",
"first_name": "RACHELLE",
"middle_name": "L",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-18",
"last_updated": "2012-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IA",
"license": "3803",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1891990271",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Windsor Heights, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.