NPIMap

Individual provider Active NPI

Pamela A Hetzel, DNP

  • Acute Care Nurse Practitioner
  • Council Bluffs, IA
National Provider Identifier
1902644685
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
H165041 Issued in IA
Practice address
900 Woodbury Ave Ste 8B
Council Bluffs, IA 51503-7855
Phone
(712) 796-2545
Fax
(712) 847-6095
NPI assigned
Jul 17, 2024
Last updated
Jan 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X H165041 IA Primary
Acute Care Nurse Practitioner 363LA2100X 113960 NE

Addresses

Primary practice location

900 Woodbury Ave Ste 8B
Council Bluffs, IA 51503-7855

Mailing address

900 Woodbury Ave Ste 8B
Council Bluffs, IA 51503-7855
Phone (712) 796-2545

Other practice location 1

103 North Ave Ste 8
Council Bluffs, IA 51503
Phone (712) 796-2545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241107002716 NE Practitioner - Nurse Practitioner 4587198999 Reassigns benefits to 1 organization
I20241115004031 IA Practitioner - Nurse Practitioner 4587198999 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Kidney Care, PLLCGroup PAC ID 2769830082, 5 clinicians

Practice addresses (Care Compare)

103 N Ave
Suite 8
Council Bluffs, IA 51503-1613
Phone (712) 796-2545

3339 L St
Omaha, NE 68107-2500
Phone (402) 734-0772

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
H165041IAMDAcute Care Nurse Practitioner
113960NEMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Kidney Care PLLC CurrentSince Nov 1, 2024 Accepting new patients
Shenandoah Medical Center CurrentSince Jan 19, 2026 Accepting new patients
Shenandoah Medical Center CurrentSince Jan 19, 2026 Accepting new patients

Locations

103 North Ave
Ste 8
Council Bluffs, IA 51503
Phone (712) 220-2203

800 Mercy Dr
Council Bluffs, IA 51503
Phone (712) 328-5000

900 Woodbury Ave
Ste 8B
Council Bluffs, IA 51503
Phone (712) 328-2225

1 Jack Foster Dr
Shenandoah, IA 51601
Phone (712) 246-7240

300 Pershing Ave
Shenandoah, IA 51601
Phone (712) 246-1230

3339 L St
Omaha, NE 68107
Phone (402) 734-0772

6212 N 73rd Plz
Ste 100
Omaha, NE 68134
Phone (402) 571-4147

8303 W Dodge Rd
Omaha, NE 68114
Phone (402) 354-4000

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1721174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1902644685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 WOODBURY AVE STE 8B",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515037855",
            "telephone_number": "712-796-2545",
            "fax_number": "712-847-6095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WOODBURY AVE STE 8B",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515037855",
            "telephone_number": "712-796-2545",
            "fax_number": "712-847-6095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 North Ave Ste 8",
            "address_purpose": "LOCATION",
            "city": "Council Bluffs",
            "state": "IA",
            "postal_code": "51503",
            "country_code": "US",
            "telephone_number": "712-796-2545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HETZEL",
        "first_name": "PAMELA",
        "middle_name": "A",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-17",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IA",
            "license": "H165041",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NE",
            "license": "113960",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

Verify at the official NPI Registry.