Individual provider Active NPI

Sally Twedt, CPNP,ARNP

  • Pediatric Nurse Practitioner
  • Des Moines, IA
National Provider Identifier
1972578722
Registry record updated Oct 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
C-098350 Issued in IA
Practice address
2301 Beaver Ave
Des Moines, IA 50310-3903
Phone
(515) 255-3181
Fax
(515) 255-9392
NPI assigned
Feb 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X C-098350 IA Primary

Addresses

Primary practice location

2301 Beaver Ave
Des Moines, IA 50310-3903

Mailing address

2301 Beaver Ave
Des Moines, IA 50310-3903
Phone (515) 255-3181

Other identifiers 1

IdentifierTypeStateIssuer
0477943MedicaidIA

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
C-098350IAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Des Moines Pediatric & Adolescent Clinic Pediatrics Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288051200000",
    "number": "1972578722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 BEAVER AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503103903",
            "telephone_number": "515-255-3181",
            "fax_number": "515-255-9392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 BEAVER AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503103903",
            "telephone_number": "515-255-3181",
            "fax_number": "515-255-9392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TWEDT",
        "first_name": "SALLY",
        "name_prefix": "Ms.",
        "credential": "CPNP,ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-22",
        "last_updated": "2010-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IA",
            "license": "C-098350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0477943",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; 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.