Individual provider Active NPI

Raelee Lynn Bird, ARNP

  • Nurse Practitioner
  • North Liberty, IA
National Provider Identifier
1982106712
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
H137415 Issued in IA
Practice address
125 E Zeller St Ste D
North Liberty, IA 52317-9248
Phone
(319) 853-0068
NPI assigned
Mar 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 137415 IA
Nurse Practitioner 363L00000X H137415 IA Primary

Addresses

Primary practice location

125 E Zeller St Ste D
North Liberty, IA 52317-9248

Mailing address

PO Box 125
Brighton, IA 52540-0125
Phone (319) 461-6168

Other names 1

  • Raelee Lynn Wiggins Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180608000793 IA Practitioner - Nurse Practitioner 6103171491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metro Infectious Disease Consultants LLCGroup PAC ID 3072425784, 386 clinicians

Practice addresses (Care Compare)

125 E Zeller St D
North Liberty, IA 52317-9248
Phone (877) 448-3627

3230 Redhawk St
Suite 200
Coralville, IA 52241-8539
Phone (877) 448-3627

4817 University Ave
Suite a
Cedar Falls, IA 50613-6293
Phone (877) 448-3627

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
137415IAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Infectious Disease Consultants, LLC Nurse Practitioner CurrentSince Jun 1, 2018 Accepting new patients
Metro Infectious Disease Consultants LLC CurrentSince Jun 1, 2018 Accepting new patients
Metro Infectious Disease Consultants, LLC Past Accepting new patients

Locations

125 E Zeller St
Ste D
North Liberty, IA 52317
Phone (319) 214-0005

901 McClintock Dr
Ste 202
Burr Ridge, IL 60527
Phone (630) 654-4201

Organizations & group practices 4

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": "1520380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1982106712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 125",
            "city": "BRIGHTON",
            "state": "IA",
            "postal_code": "525400125",
            "telephone_number": "319-461-6168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E ZELLER ST STE D",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523179248",
            "telephone_number": "319-853-0068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRD",
        "first_name": "RAELEE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-07",
        "last_updated": "2021-06-09",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IA",
            "license": "137415",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "H137415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAELEE",
            "last_name": "WIGGINS",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in North Liberty, IA

Sources for this page

Verify at the official NPI Registry.