Council Bluffs Community Health Center

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

COUNCIL BLUFFS COMMUNITY HEALTH CENTER

Practice address

2700 College Rd
A104
Council Bluffs, IA 51503-1057

Phone

(712) 325-3351

Fax

(712) 325-3739

NPI assigned

Aug 6, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Gerri L Brunow, CPC

Title

Ar Manager

Phone

(712) 256-6577

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Council Bluffs Communit2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• All Care Health Center

  • Community/Retail Pharmacy
  • Council Bluffs, IA
  • NPI 1124461363
  NPD tax ID

Locations

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1982895942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 WEST BROADWAY",
            "address_2": "SUITE 6",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515039040",
            "telephone_number": "712-256-6577",
            "fax_number": "712-325-1932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 COLLEGE RD",
            "address_2": "A104",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515031057",
            "telephone_number": "712-325-3351",
            "fax_number": "712-325-3739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNCIL BLUFFS COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-06",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "BRUNOW",
        "authorized_official_first_name": "GERRI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "AR MANAGER",
        "authorized_official_telephone_number": "712-256-6577",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "16D0949735",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0188946",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Francis Cool
• Daniela Cortes Reyes, MD
• Patrick T. Costello, M.D.
• Yvonne A Cotton, APRN
• Council Bluffs Chiropractic Clinic LLC
• Council Bluffs Community School District
• Council Bluffs Foot & Ankle Care PC
• Council Bluffs Senior Care, LLC
• Council Bluffs Surgical Associates, P.C.
• Countryhouse Council Bluffs LLC

• Federally Qualified Health Center (FQHC) in Council Bluffs, IA
• Providers in Council Bluffs, IA by specialty
• Federally Qualified Health Center (FQHC) in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.