NPIMap

Organization Active NPI

St. Luke's Family Health Center

  • Ambulatory Family Planning Facility
  • Cedar Rapids, IA
National Provider Identifier
1962539221
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Family Planning FacilityTaxonomy code 261QA0005X
Legal business name
ST. LUKE'S FAMILY HEALTH CENTER
Practice address
855 A Ave NE
Suite Lower Level 1
Cedar Rapids, IA 52402-5057
Phone
(319) 369-7397
Fax
(319) 369-7494
NPI assigned
Feb 27, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Valerie K Campbell, RN
Title
Nurse Manager
Phone
(319) 369-7416

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Family Planning Facility 261QA0005X NU Primary

Addresses

Primary practice location

855 A Ave NE
Suite Lower Level 1
Cedar Rapids, IA 52402-5057

Mailing address

855 A Ave NE
Suite Lower Level 1
Cedar Rapids, IA 52402-5057
Phone (319) 369-7397

Other identifiers 2

IdentifierTypeStateIssuer
0021691MedicaidIA
49729OtherIABLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962539221. Details of each certification follow.

  • CCN 161845 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 161845

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
FAMILY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 24, 2007
Last certification
Oct 24, 2007
Ownership / control type
For profit – partnership
Facility address
855 A Ave NE
Cedar Rapids, IA 52402

National Provider Directory

National Provider Directory
Tax ID family
St Lukes Emergency Phy17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Locations

855 A Ave NE
Lowr
Cedar Rapids, IA 52402
Phone (319) 368-5650

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962539221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 A AVE NE",
            "address_2": "SUITE LOWER LEVEL 1",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524025057",
            "telephone_number": "319-369-7397",
            "fax_number": "319-369-7494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 A AVE NE",
            "address_2": "SUITE LOWER LEVEL 1",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524025057",
            "telephone_number": "319-369-7397",
            "fax_number": "319-369-7494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S FAMILY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "NURSE MANAGER",
        "authorized_official_telephone_number": "319-369-7416",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA0005X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Family Planning Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0021691",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "49729",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.