NPIMap

Organization Active NPI

Northwest Iowa Dermatology LLC

  • Dermatology Physician
  • Algona, IA
National Provider Identifier
1962217778
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
NORTHWEST IOWA DERMATOLOGY LLC
Practice address
114 N Dodge St
Algona, IA 50511-2636
Phone
(515) 622-7060
Fax
(515) 293-4481
NPI assigned
Feb 10, 2025
Last updated
Apr 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Authorized official

Name
Caitlin McConnellNPI 1639812597
Title
Arnp, FNP-C
Phone
(712) 298-0748

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

114 N Dodge St
Algona, IA 50511-2636

Mailing address

PO Box 751
Okoboji, IA 51355-0751
Phone (515) 416-8776

Other practice location 1

1200 1st Ave E Ste 1
Spencer, IA 51301-4330
Phone (712) 264-6198

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250423000784 IA Part B Supplier - Clinic/Group Practice 1557886470 Receives reassigned benefits from 1 practitioner
Practice locations: Algona, IA; Spencer, IA

National Provider Directory

National Provider Directory

Locations

114 N Dodge St
Algona, IA 50511
Phone (515) 416-8776

1200 1st Ave E
Ste 1
Spencer, IA 51301
Phone (712) 264-6160

Practitioners & affiliated clinicians

Practitioners 51

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.

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1739145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745366400000",
    "number": "1962217778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751",
            "city": "OKOBOJI",
            "state": "IA",
            "postal_code": "513550751",
            "telephone_number": "515-416-8776",
            "fax_number": "515-513-0728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 N DODGE ST",
            "city": "ALGONA",
            "state": "IA",
            "postal_code": "505112636",
            "telephone_number": "515-622-7060",
            "fax_number": "515-293-4481"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 1st Ave E Ste 1",
            "address_purpose": "LOCATION",
            "city": "Spencer",
            "state": "IA",
            "postal_code": "513014330",
            "country_code": "US",
            "telephone_number": "712-264-6198",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTHWEST IOWA DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A",
        "authorized_official_last_name": "MCCONNELL",
        "authorized_official_first_name": "CAITLIN",
        "authorized_official_title_or_position": "ARNP, FNP-C",
        "authorized_official_telephone_number": "712-298-0748"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Algona, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.