Preventative Health Clinic Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

03475 Issued in IA

Legal business name

PREVENTATIVE HEALTH CLINIC INC

Practice address

2480 Berkshire Pkwy
Clive, IA 50325-4678

Phone

(515) 225-2578

Fax

(515) 225-2598

NPI assigned

Mar 13, 2008

Last updated

Dec 2, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Angelia Renee Whetro, DO

Title

Med Director

Phone

(515) 225-2578

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Susan L. Cross, ARNP, BC-ADM

  • Nurse Practitioner
  • Clive, IA
  • NPI 1992793723
  NPD (past)

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228176000000",
    "number": "1922279439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 GRAND AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503125305",
            "telephone_number": "515-237-3974",
            "fax_number": "515-883-2692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 BERKSHIRE PKWY",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503254678",
            "telephone_number": "515-225-2578",
            "fax_number": "515-225-2598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTATIVE HEALTH CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-13",
        "last_updated": "2008-12-02",
        "status": "A",
        "authorized_official_last_name": "WHETRO",
        "authorized_official_first_name": "ANGELIA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "MED DIRECTOR",
        "authorized_official_telephone_number": "515-225-2578",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "001132",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007026",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "03475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ethan Pottebaum, DC
• Sarah Potter, MS, BCBA
• Jessica A Pottorff, MS, MA, CADC, LMHC
• Alicia Pralle, M.A., CCC-SLP
• Rachel Ann Berger Preisser, M.D.
• Profound Pathways
• Adam Puls
• Pure Wellness Chiropractic & Acupuncture
• Natalie Michele Ramirez
• Renae Randel, TLMHC

• Family Medicine Physician in Clive, IA
• Providers in Clive, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2008; 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.