Mark R Poeppe, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

091847 Issued in IA

Practice address

12951 University Ave Ste 204
Clive, IA 50325-8293

Phone

(515) 575-3180

NPI assigned

Aug 2, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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.

• Poeppe Expert Psychological Services PLLC

  • Mental Health Counselor
  • Clive, IA
  • NPI 1235737362
  Authorized official Same address or phone

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

{
    "created_epoch": "1533168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1962980771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12951 UNIVERSITY AVE STE 204",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258293",
            "telephone_number": "515-575-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12951 UNIVERSITY AVE STE 204",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258293",
            "telephone_number": "515-575-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POEPPE",
        "first_name": "MARK",
        "middle_name": "R",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-02",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IA",
            "license": "091847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Anne Pieper
• Todd Randall Pietig, O.D.
• Kate Pithan, PA-C
• Shana Plambeck
• Poeppe Expert Psychological Services PLLC
• Lily Pokornowski
• Possibilities Therapy LLC
• Benjamin Pottebaum, D.O.
• Ethan Pottebaum, DC
• Sarah Potter, MS, BCBA

• Psychologist in Clive, IA
• Providers in Clive, IA by specialty
• Psychologist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.