| Heartland Family Service | |
|
515 E Broadway Council Bluffs IA 51503 | |
| (712) 322-1407 | |
| (712) 322-6833 |
| Full Name | Heartland Family Service |
|---|---|
| Speciality | Clinic/Center |
| Location | 515 E Broadway, Council Bluffs, Iowa |
| Authorized Official Name and Position | John Jeanetta (PRESIDENT CEO) |
| Authorized Official Contact | 4025527402 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heartland Family Service 2101 S 42nd St Omaha NE 68105-2909 Ph: (402) 553-3000 | Heartland Family Service 515 E Broadway Council Bluffs IA 51503 Ph: (712) 322-1407 |
| NPI Number | 1316009475 |
|---|---|
| Provider Enumeration Date | 12/15/2006 |
| Last Update Date | 09/01/2010 |
| Medicare PECOS PAC ID | 7315833506 |
|---|---|
| Medicare Enrollment ID | O20081218000069 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316009475 | NPI | - | NPPES |
| Provider Name | Dianna Prokupek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194797449 PECOS PAC ID: 8628013588 Enrollment ID: I20050622000538 |
| Provider Name | Michael Lee Coy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124152780 PECOS PAC ID: 4082655055 Enrollment ID: I20080508000770 |
| Provider Name | Terry M Ideker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326227224 PECOS PAC ID: 2264590843 Enrollment ID: I20090327000300 |
| Provider Name | David B Walker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003004391 PECOS PAC ID: 6305000993 Enrollment ID: I20120612000130 |
| Provider Name | Shelli J Reams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841641230 PECOS PAC ID: 5193150993 Enrollment ID: I20200125000156 |
| Provider Name | Lauren A Campbell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225568793 PECOS PAC ID: 9133555410 Enrollment ID: I20200205000138 |
| Provider Name | Kaitlin Carlson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780167676 PECOS PAC ID: 7911395900 Enrollment ID: I20211025000798 |
| Provider Name | Alfred Ongesa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013688530 PECOS PAC ID: 2163810151 Enrollment ID: I20211025000953 |
| Provider Name | Karen Baber |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831813674 PECOS PAC ID: 0547638959 Enrollment ID: I20221116000434 |
| Provider Name | Gerardo Guerrero-segura |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417637893 PECOS PAC ID: 0446613103 Enrollment ID: I20230828003342 |
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