Individual provider Active NPI

Rachelle L Gammon, DO

  • Pediatrics Physician
  • Windsor Heights, IA
National Provider Identifier
1891990271
Registry record updated May 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
3803 Issued in IA
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

Updated by the provider on May 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1891990271MedicaidIA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
3803IAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Methodist Hospital Current Accepting new patients
Iowa Physicians Clinic Medical Foundation Pediatrics CurrentSince Aug 15, 2007 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.