| Backbone Area Counseling Center | |
|
709 W Main St Manchester IA 52057-1526 | |
| (563) 927-7330 | |
| (563) 927-7409 |
| Full Name | Backbone Area Counseling Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 709 W Main St, Manchester, Iowa |
| Authorized Official Name and Position | Lon Butikofer (CEO) |
| Authorized Official Contact | 5639273232 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Backbone Area Counseling Center 709 W Main St Manchester IA 52057-1526 Ph: (563) 927-7330 | Backbone Area Counseling Center 709 W Main St Manchester IA 52057-1526 Ph: (563) 927-7330 |
| NPI Number | 1982667929 |
|---|---|
| Provider Enumeration Date | 04/10/2006 |
| Last Update Date | 01/29/2008 |
| Medicare PECOS PAC ID | 2062316375 |
|---|---|
| Medicare Enrollment ID | O20031119000881 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982667929 | NPI | - | NPPES |
| 09971 | Other | IA | BCIA |
| 0091637 | Medicaid | IA | |
| 0279307 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Perry Comeau |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386644615 PECOS PAC ID: 7315831575 Enrollment ID: I20040210000496 |
| Provider Name | Mark G Odden |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1528022993 PECOS PAC ID: 4880582600 Enrollment ID: I20040304000924 |
| Provider Name | Blanka Divisova |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023085644 PECOS PAC ID: 7810887940 Enrollment ID: I20040319001069 |
| Provider Name | Nicole M Salow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831178060 PECOS PAC ID: 5799777561 Enrollment ID: I20040401000213 |
| Provider Name | Jeffrey J Hoffmann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295724037 PECOS PAC ID: 5991792475 Enrollment ID: I20040428000224 |
| Provider Name | Andrew C Peterson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568460061 PECOS PAC ID: 7416938485 Enrollment ID: I20040526000376 |
| Provider Name | Scott D Geisler |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336147933 PECOS PAC ID: 4486637576 Enrollment ID: I20040610000137 |
| Provider Name | Matt A Morgan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1447275722 PECOS PAC ID: 1557346772 Enrollment ID: I20040622000926 |
| Provider Name | Jeffrey J Curnes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831165695 PECOS PAC ID: 6800871666 Enrollment ID: I20040624000221 |
| Provider Name | Sue Ann Gingerich |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1699779546 PECOS PAC ID: 4284611872 Enrollment ID: I20040715000356 |
| Provider Name | Jonathan M Rippentrop |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1609874171 PECOS PAC ID: 6800860586 Enrollment ID: I20040820000028 |
| Provider Name | Craig B Thompson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013923341 PECOS PAC ID: 1557338225 Enrollment ID: I20040913000727 |
| Provider Name | Scot Christiansen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417955089 PECOS PAC ID: 0648187617 Enrollment ID: I20041123000552 |
| Provider Name | Daniel A Mansfield |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942204300 PECOS PAC ID: 0345148664 Enrollment ID: I20041202000880 |
| Provider Name | David M Huether |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1033149133 PECOS PAC ID: 5597716001 Enrollment ID: I20050202000277 |
| Provider Name | Cassandra S Lange |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1497753156 PECOS PAC ID: 9638129521 Enrollment ID: I20050203000995 |
| Provider Name | Lisa A Tyler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518910678 PECOS PAC ID: 0446204994 Enrollment ID: I20050524001340 |
| Provider Name | Janice M Budzine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174521777 PECOS PAC ID: 2769485960 Enrollment ID: I20060808000395 |
| Provider Name | Richard J Unger |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245267939 PECOS PAC ID: 7911901665 Enrollment ID: I20060912000145 |
| Provider Name | Ryan K Sundermann |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447219746 PECOS PAC ID: 6901804327 Enrollment ID: I20061120000288 |
| Provider Name | William John Specht |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396829834 PECOS PAC ID: 2769483866 Enrollment ID: I20070117000231 |
| Provider Name | Ralph R Boom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720086275 PECOS PAC ID: 2466416342 Enrollment ID: I20070205000032 |
| Provider Name | James S Gill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578540241 PECOS PAC ID: 3173525037 Enrollment ID: I20070205000688 |
| Provider Name | Steven R Mindrup |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1447298005 PECOS PAC ID: 5890707517 Enrollment ID: I20070504000420 |
| Provider Name | Robert John Struthers |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982738795 PECOS PAC ID: 3375641467 Enrollment ID: I20070613000699 |
| Provider Name | Mary L Lamar |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1134326952 PECOS PAC ID: 7012008022 Enrollment ID: I20070806000508 |
| Provider Name | Bethany J Stevens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598969701 PECOS PAC ID: 5092806927 Enrollment ID: I20070807000807 |
| Provider Name | Timothy Paul Gerst |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861480139 PECOS PAC ID: 0547214470 Enrollment ID: I20070830000034 |
| Provider Name | Michelle S Radloff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376742825 PECOS PAC ID: 5991899387 Enrollment ID: I20070920000371 |
| Provider Name | Craig A Hovda |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366418139 PECOS PAC ID: 2466530126 Enrollment ID: I20080421000416 |
| Provider Name | Katherine T Gansen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609024652 PECOS PAC ID: 1759459100 Enrollment ID: I20081013000049 |
| Provider Name | Tonya J Hasleiet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033363205 PECOS PAC ID: 7618030107 Enrollment ID: I20090109000188 |
| Provider Name | Janet R Eimers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902041312 PECOS PAC ID: 7810051364 Enrollment ID: I20090127000701 |
| Provider Name | Maria A Farmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427204577 PECOS PAC ID: 5597820845 Enrollment ID: I20090219000593 |
| Provider Name | Ann M Wilson Bries |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467609164 PECOS PAC ID: 1759438815 Enrollment ID: I20090408000102 |
| Provider Name | William K Barnhill |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1710962519 PECOS PAC ID: 9436041068 Enrollment ID: I20090506000283 |
| Provider Name | Randy D Cornelius |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1831353051 PECOS PAC ID: 3173674140 Enrollment ID: I20090702000340 |
| Provider Name | Jane Hartnett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659379279 PECOS PAC ID: 9739096702 Enrollment ID: I20090918000095 |
| Provider Name | Logan D Hoxie |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1285632778 PECOS PAC ID: 2769524503 Enrollment ID: I20100116000360 |
| Provider Name | Jeffrey S Wilson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1962485326 PECOS PAC ID: 7416090485 Enrollment ID: I20100130000230 |
| Provider Name | Douglas M Cooper |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1770576050 PECOS PAC ID: 4082743455 Enrollment ID: I20100522000134 |
| Provider Name | Beth Ann Sadewasser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356330161 PECOS PAC ID: 7517096852 Enrollment ID: I20100526000048 |
| Provider Name | Ryan D Dempewolf |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1912116492 PECOS PAC ID: 0941333231 Enrollment ID: I20100806000781 |
| Provider Name | Jill Buschmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568460178 PECOS PAC ID: 5092849513 Enrollment ID: I20100818001164 |
| Provider Name | Sarah R Kluesner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679889661 PECOS PAC ID: 5395861868 Enrollment ID: I20100922000617 |
| Provider Name | Amber M. Jaeger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477867026 PECOS PAC ID: 1850583055 Enrollment ID: I20101006000774 |
| Provider Name | Mathew W Severidt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215191523 PECOS PAC ID: 6204021041 Enrollment ID: I20101105001297 |
| Provider Name | Victor A Salas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982679429 PECOS PAC ID: 9537192737 Enrollment ID: I20101124000827 |
| Provider Name | Scott J Chastek |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1487701652 PECOS PAC ID: 2062512171 Enrollment ID: I20110215000922 |
| Provider Name | Jennifer M Chastek |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1730483645 PECOS PAC ID: 4587846308 Enrollment ID: I20110315000462 |
| Provider Name | Charlene Sauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174829840 PECOS PAC ID: 2567646631 Enrollment ID: I20110414000181 |
| Provider Name | Bryce A Hoffman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437385861 PECOS PAC ID: 3577749159 Enrollment ID: I20110516000732 |
| Provider Name | Kristen Marie Jensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811285950 PECOS PAC ID: 3274705488 Enrollment ID: I20111012000688 |
| Provider Name | Elizabeth M Giedt |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1023380755 PECOS PAC ID: 2860650553 Enrollment ID: I20120227000677 |
| Provider Name | Sara Elizabeth Burnham |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801022694 PECOS PAC ID: 2466616438 Enrollment ID: I20120605000055 |
| Provider Name | Jennifer M Burds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639433030 PECOS PAC ID: 4587811922 Enrollment ID: I20120820001161 |
| Provider Name | Michelle R Ladeburg-jeanes |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1194078873 PECOS PAC ID: 1153576251 Enrollment ID: I20130220000558 |
| Provider Name | Sarah J Hartman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851635304 PECOS PAC ID: 3476708025 Enrollment ID: I20130305000166 |
| Provider Name | Natasha J Broom |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1649577586 PECOS PAC ID: 0446493605 Enrollment ID: I20130909000138 |
| Provider Name | Daniel J Howlett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326488420 PECOS PAC ID: 3577791482 Enrollment ID: I20140122000406 |
| Provider Name | Denise Lympus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659713675 PECOS PAC ID: 7719115534 Enrollment ID: I20140123002065 |
| Provider Name | Tara Mescher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689002495 PECOS PAC ID: 0648409185 Enrollment ID: I20140204000932 |
| Provider Name | Treesa A Silver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134421837 PECOS PAC ID: 7416187885 Enrollment ID: I20140304001111 |
| Provider Name | Berri E Swasand |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1609814193 PECOS PAC ID: 7719879345 Enrollment ID: I20140307001603 |
| Provider Name | Treesa A Silver |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1134421837 PECOS PAC ID: 7416187885 Enrollment ID: I20140310000786 |
| Provider Name | Clinton Thomas Cummings |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083908263 PECOS PAC ID: 4385875848 Enrollment ID: I20140326000705 |
| Provider Name | Gregg A Drabek |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1629180054 PECOS PAC ID: 5890785034 Enrollment ID: I20140403001328 |
| Provider Name | Bridget M Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245654847 PECOS PAC ID: 0941432140 Enrollment ID: I20140422000194 |
| Provider Name | Nikolas S May |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508156159 PECOS PAC ID: 5698917482 Enrollment ID: I20140917002582 |
| Provider Name | Nicolette Mabb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629487632 PECOS PAC ID: 4688894058 Enrollment ID: I20141007001046 |
| Provider Name | Phillip R Hurd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194054312 PECOS PAC ID: 1759423312 Enrollment ID: I20150403000429 |
| Provider Name | Gregory M Janda |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1245473453 PECOS PAC ID: 4880815232 Enrollment ID: I20150710000069 |
| Provider Name | Carly Y Roskop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083096663 PECOS PAC ID: 3779896857 Enrollment ID: I20150717002374 |
| Provider Name | Brady N Blazek |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1780924118 PECOS PAC ID: 6305151812 Enrollment ID: I20150812009015 |
| Provider Name | Amanda S Olberding |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164835138 PECOS PAC ID: 6103041819 Enrollment ID: I20150821014695 |
| Provider Name | Bradley W Zeithamel |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1568768752 PECOS PAC ID: 4486960119 Enrollment ID: I20150826001044 |
| Provider Name | Jonathan D Schettler |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1760722573 PECOS PAC ID: 3779891247 Enrollment ID: I20151002000162 |
| Provider Name | Brittany Wulfekuhle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770951162 PECOS PAC ID: 9638488356 Enrollment ID: I20151021000041 |
| Provider Name | Krissy J Wieland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801263462 PECOS PAC ID: 1557670825 Enrollment ID: I20151028000248 |
| Provider Name | April M Ehrler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619349222 PECOS PAC ID: 3678874856 Enrollment ID: I20151211001415 |
| Provider Name | Faith Sang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922470988 PECOS PAC ID: 6002119203 Enrollment ID: I20160121002093 |
| Provider Name | Michelle M Wenzel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639522899 PECOS PAC ID: 8527352038 Enrollment ID: I20160805001774 |
| Provider Name | Christina Kullmer |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1235221425 PECOS PAC ID: 9537144399 Enrollment ID: I20160822002207 |
| Provider Name | Courtney L Messerly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992148738 PECOS PAC ID: 6800018904 Enrollment ID: I20161031000831 |
| Provider Name | Alindsey J Kramer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386095297 PECOS PAC ID: 0547543944 Enrollment ID: I20170209000648 |
| Provider Name | Jodi Marie Helle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114456308 PECOS PAC ID: 7810267739 Enrollment ID: I20170725002551 |
| Provider Name | Stephanie Marie Gudenkauf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659800480 PECOS PAC ID: 5597035345 Enrollment ID: I20170726004234 |
| Provider Name | Sarah M Tweedy |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1114304128 PECOS PAC ID: 5698047165 Enrollment ID: I20170817002185 |
| Provider Name | Shawn C Blake |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1821475849 PECOS PAC ID: 9830461359 Enrollment ID: I20170817004188 |
| Provider Name | Cara Lynn Paris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609306398 PECOS PAC ID: 1557633559 Enrollment ID: I20170825003039 |
| Provider Name | Zarrish Saeed Khan |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1194925032 PECOS PAC ID: 0042435562 Enrollment ID: I20180215000126 |
| Provider Name | Richard Y Jacobson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1023042686 PECOS PAC ID: 7810097045 Enrollment ID: I20180417001153 |
| Provider Name | Benjamin A Levinson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1205298668 PECOS PAC ID: 0446508956 Enrollment ID: I20180731001885 |
| Provider Name | Grace Hsuanhwa Wang |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043324247 PECOS PAC ID: 7911897228 Enrollment ID: I20180831000511 |
| Provider Name | John E Player |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1285965905 PECOS PAC ID: 9931235801 Enrollment ID: I20180913000902 |
| Provider Name | Samantha J Specht |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1982066593 PECOS PAC ID: 2264785112 Enrollment ID: I20181023003725 |
| Provider Name | Michael A Moriarty |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1487072112 PECOS PAC ID: 5395038913 Enrollment ID: I20190702000083 |
| Provider Name | Tiffanie L Lapan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1215590153 PECOS PAC ID: 6608103320 Enrollment ID: I20190802002563 |
| Provider Name | Brooke M Cooney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740841196 PECOS PAC ID: 0143558817 Enrollment ID: I20190820002577 |
| Provider Name | Karen Schmitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356907778 PECOS PAC ID: 8921336819 Enrollment ID: I20190830001473 |
| Provider Name | Kaitlin Rose Reece |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225666894 PECOS PAC ID: 5496185399 Enrollment ID: I20200416002241 |
| Provider Name | Connie Marie Bruch-harrison |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1184626194 PECOS PAC ID: 5193799963 Enrollment ID: I20200713003009 |
| Provider Name | Thomas E Heineman |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1881089704 PECOS PAC ID: 6406109099 Enrollment ID: I20200805002044 |
| Provider Name | Molly M Olson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124552591 PECOS PAC ID: 8820368681 Enrollment ID: I20200819002855 |
| Provider Name | Travis Jon Smith |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1740443803 PECOS PAC ID: 5799941506 Enrollment ID: I20200923001290 |
| Provider Name | Fernando Escobar |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548265994 PECOS PAC ID: 0648294884 Enrollment ID: I20201007002363 |
| Provider Name | Derek Manson Dzaboff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407454044 PECOS PAC ID: 7012327430 Enrollment ID: I20201113000198 |
| Provider Name | Darcie Marie Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215536636 PECOS PAC ID: 3274944913 Enrollment ID: I20201201001549 |
| Provider Name | Anne M Meyer-mccright |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1154490837 PECOS PAC ID: 4981676830 Enrollment ID: I20201214001408 |
| Provider Name | Griffin S Kopp |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073120754 PECOS PAC ID: 7315351566 Enrollment ID: I20210128002502 |
| Provider Name | Anthony Robert Greenwood |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1811504590 PECOS PAC ID: 1254745417 Enrollment ID: I20210128002887 |
| Provider Name | Mark Allan Meier |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083671572 PECOS PAC ID: 0143242891 Enrollment ID: I20210225001884 |
| Provider Name | Andrew H Rikkers |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558455386 PECOS PAC ID: 9739125766 Enrollment ID: I20210303001065 |
| Provider Name | Jonathan Robert Lang |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1790349157 PECOS PAC ID: 0244630044 Enrollment ID: I20210616001499 |
| Provider Name | Isaac A Butler |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1003470451 PECOS PAC ID: 9739580150 Enrollment ID: I20210623001204 |
| Provider Name | Dana A Mormann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356914469 PECOS PAC ID: 4183027964 Enrollment ID: I20210730003047 |
| Provider Name | Herman Burgermeister |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215953492 PECOS PAC ID: 1658552120 Enrollment ID: I20210922000889 |
| Provider Name | Kellie J Goos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841945821 PECOS PAC ID: 5496149452 Enrollment ID: I20220308002286 |
| Provider Name | Cindy Marie Snyder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609524990 PECOS PAC ID: 1052706298 Enrollment ID: I20220324002098 |
| Provider Name | Sara Mae Mccool |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932857810 PECOS PAC ID: 5496035651 Enrollment ID: I20220325001377 |
| Provider Name | Mindy Jean Mensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588320972 PECOS PAC ID: 2365818010 Enrollment ID: I20221020000986 |
| Provider Name | Jordan S Miller |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1689175200 PECOS PAC ID: 9739436981 Enrollment ID: I20221212002796 |
| Provider Name | James Oliver Cody |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1033834569 PECOS PAC ID: 7810368024 Enrollment ID: I20230126002224 |
| Provider Name | Travis R Schulze |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073248951 PECOS PAC ID: 7618330606 Enrollment ID: I20230823003048 |
| Provider Name | Sabrina Provvidenza Vitale-d'angelo |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962088104 PECOS PAC ID: 9335502061 Enrollment ID: I20230829002347 |
| Provider Name | Matthew Bodine |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1295519072 PECOS PAC ID: 9436503067 Enrollment ID: I20230929001703 |
| Provider Name | Angela M Wicks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508040940 PECOS PAC ID: 5698123156 Enrollment ID: I20231122002075 |
| Provider Name | Bruce A Gregory |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316014046 PECOS PAC ID: 6204284516 Enrollment ID: I20231128000587 |
| Provider Name | Seth Nicolas Additon |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336848282 PECOS PAC ID: 0648621995 Enrollment ID: I20240110004816 |
| Provider Name | Nicole Brehm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063033413 PECOS PAC ID: 8527404912 Enrollment ID: I20240307002220 |
Waves Healing Therapy, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 105 E Butler St, Manchester, IA 52057 Phone: 563-929-6571 | |
Delaware County Community Life Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 601 Grant Street, Manchester, IA 52057 Phone: 563-927-1077 | |
Abbe Center For Cmh @ Manchester Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 721 South 5th St, Manchester, IA 52057 Phone: 563-927-6700 Fax: 563-927-6703 |