Full Name | |
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Speciality | Family Medicine |
Location | 1219 Main St, Hamburg, Iowa |
Authorized Official Name and Position | Cristin A Hendrickson (CEO) |
Authorized Official Contact | 7123821515 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1219 Main St Hamburg IA 51640-1300 Ph: (712) 382-2626 | 1219 Main St Hamburg IA 51640-1300 Ph: (712) 382-2626 |
NPI Number | 1124218706 |
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Provider Enumeration Date | 07/30/2007 |
Last Update Date | 08/12/2024 |
Medicare PECOS PAC ID | 5395634216 |
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Medicare Enrollment ID | O20071003000602 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124218706 | NPI | - | NPPES |
0018507 | Medicaid | IA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Michael J Ourada |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1427164789 PECOS PAC ID: 2769370402 Enrollment ID: I20040305000345 |
Provider Name | Kelli E Woltemath |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1285606731 PECOS PAC ID: 1951294982 Enrollment ID: I20051229000612 |
Provider Name | Alisha Jolene Thompson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710559083 PECOS PAC ID: 7618155466 Enrollment ID: I20210721002655 |
Provider Name | Paige Michelle Jones |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710655352 PECOS PAC ID: 8123405149 Enrollment ID: I20220512002729 |
Provider Name | Brooke Alex Hollars |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235963786 PECOS PAC ID: 9032641998 Enrollment ID: I20241016002801 |
Provider Name | Laura Gene Isaacson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083443527 PECOS PAC ID: 0749712313 Enrollment ID: I20241022003791 |