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901 Montgomery St Decorah IA 52101-2325 | |
| (563) 382-2911 | |
| (563) 387-3102 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 901 Montgomery St, Decorah, Iowa |
| Authorized Official Name and Position | Steven Slessor (CAO) |
| Authorized Official Contact | 5633873145 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
901 Montgomery St Decorah IA 52101-2325 Ph: (563) 382-2911 | 901 Montgomery St Decorah IA 52101-2325 Ph: (563) 382-2911 |
| NPI Number | 1992854863 |
|---|---|
| Provider Enumeration Date | 01/09/2007 |
| Last Update Date | 06/29/2023 |
| Medicare PECOS PAC ID | 4688582935 |
|---|---|
| Medicare Enrollment ID | O20040316001437 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992854863 | NPI | - | NPPES |
| 1100830 | Medicaid | IA | |
| 0102243 | Medicaid | IA | |
| 2100830 | Medicaid | IA | |
| 0100830 | Medicaid | IA | |
| 4100830 | Medicaid | IA | |
| 5100830 | Medicaid | IA | |
| 0121285 | Medicaid | IA | |
| 0704253 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 960127H (Iowa) | Primary |
| Provider Name | Marcia A Rosendahl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871579177 PECOS PAC ID: 4587634381 Enrollment ID: I20040729000078 |
| Provider Name | Todd E Schissel |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1790758753 PECOS PAC ID: 3971575770 Enrollment ID: I20040811001111 |
| Provider Name | Kristen Nanke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245248004 PECOS PAC ID: 0244204857 Enrollment ID: I20040820000269 |
| Provider Name | Emily L Young Johnson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1427056779 PECOS PAC ID: 6002885043 Enrollment ID: I20040928000073 |
| Provider Name | Ann E Grimstad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912901364 PECOS PAC ID: 5890755367 Enrollment ID: I20041019000394 |
| Provider Name | Daniel Borgeson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1033183520 PECOS PAC ID: 7719940477 Enrollment ID: I20041104000681 |
| Provider Name | Kevin E Locke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427052877 PECOS PAC ID: 4082512306 Enrollment ID: I20041202000858 |
| Provider Name | Ronald K Hougen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275537623 PECOS PAC ID: 7214993161 Enrollment ID: I20041202000895 |
| Provider Name | Kathy L Petersburg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508860974 PECOS PAC ID: 9830155340 Enrollment ID: I20041207000364 |
| Provider Name | William J Remington |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1730183104 PECOS PAC ID: 5698673929 Enrollment ID: I20041207000410 |
| Provider Name | Rebecca L Gesing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124023833 PECOS PAC ID: 3072570944 Enrollment ID: I20041213000214 |
| Provider Name | Donald J Hagler |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1942206016 PECOS PAC ID: 4587617386 Enrollment ID: I20050221000698 |
| Provider Name | Sarah Wymer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649231622 PECOS PAC ID: 4082668629 Enrollment ID: I20050308000291 |
| Provider Name | Hon-chi Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477526101 PECOS PAC ID: 8628088317 Enrollment ID: I20060425000738 |
| Provider Name | Scott Bohner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447273495 PECOS PAC ID: 2961406756 Enrollment ID: I20060911000166 |
| Provider Name | Thomas K Marquardt |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1841245131 PECOS PAC ID: 7810975968 Enrollment ID: I20061205000210 |
| Provider Name | Andy G Goodner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548214190 PECOS PAC ID: 7618977505 Enrollment ID: I20061227000039 |
| Provider Name | David A Foley |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1699751610 PECOS PAC ID: 3577502988 Enrollment ID: I20070319000509 |
| Provider Name | Bethany J Stevens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598969701 PECOS PAC ID: 5092806927 Enrollment ID: I20070807000807 |
| Provider Name | Wayne Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912986183 PECOS PAC ID: 3577655976 Enrollment ID: I20070815000202 |
| Provider Name | Rebecca L Moonen |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1215017157 PECOS PAC ID: 5698859973 Enrollment ID: I20080226000126 |
| Provider Name | Craig A Hovda |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366418139 PECOS PAC ID: 2466530126 Enrollment ID: I20080421000416 |
| Provider Name | Tedd Gentry |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1902804529 PECOS PAC ID: 7911814983 Enrollment ID: I20080614000109 |
| Provider Name | Ryan L Smith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356328314 PECOS PAC ID: 1254393150 Enrollment ID: I20080910000225 |
| Provider Name | Sunil V Mankad |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1912908401 PECOS PAC ID: 5294739298 Enrollment ID: I20080916000354 |
| Provider Name | Paula Gill |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1750363909 PECOS PAC ID: 1557392883 Enrollment ID: I20081008000360 |
| Provider Name | Laurie K Tope |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871755793 PECOS PAC ID: 9931255593 Enrollment ID: I20090923000312 |
| Provider Name | Elizabeth Leschensky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851373443 PECOS PAC ID: 8527196427 Enrollment ID: I20100513001080 |
| Provider Name | Richard R Remark |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1649222365 PECOS PAC ID: 5395739593 Enrollment ID: I20101013001219 |
| Provider Name | Tyler C Menke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639304348 PECOS PAC ID: 1355487026 Enrollment ID: I20101014001372 |
| 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 | Geoffrey B Johnson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346263407 PECOS PAC ID: 8224032669 Enrollment ID: I20110414000337 |
| Provider Name | Paul G Wenner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023248614 PECOS PAC ID: 5092990374 Enrollment ID: I20110502000313 |
| Provider Name | Sunil S Khanna |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1033195797 PECOS PAC ID: 0244414795 Enrollment ID: I20120201000728 |
| Provider Name | Dean M Beinborn |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194736371 PECOS PAC ID: 7012815715 Enrollment ID: I20120409000667 |
| Provider Name | Robert F Rea |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1689651689 PECOS PAC ID: 5597869800 Enrollment ID: I20120424000185 |
| Provider Name | Jessica E Thesing |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1003090507 PECOS PAC ID: 2062595200 Enrollment ID: I20120503000712 |
| Provider Name | Evan R Nelson |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1154323467 PECOS PAC ID: 4183674799 Enrollment ID: I20120725000753 |
| Provider Name | Melissa M Simon |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710100938 PECOS PAC ID: 2961696919 Enrollment ID: I20120816000941 |
| Provider Name | Anna M Ryan |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1437133964 PECOS PAC ID: 7719954502 Enrollment ID: I20130722000200 |
| Provider Name | Kirsten M Wyffels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275619223 PECOS PAC ID: 1557361482 Enrollment ID: I20130729000046 |
| Provider Name | Samantha Jo Mikota Reicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508208042 PECOS PAC ID: 6002043049 Enrollment ID: I20131218001030 |
| Provider Name | Erik K St Louis |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1922090851 PECOS PAC ID: 2264509439 Enrollment ID: I20140307001108 |
| Provider Name | Eric J Olson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1225000722 PECOS PAC ID: 1355485400 Enrollment ID: I20140415002250 |
| Provider Name | Raymond R Auger |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497725519 PECOS PAC ID: 0446265086 Enrollment ID: I20140527000785 |
| Provider Name | Alexandra Engelken |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1558770545 PECOS PAC ID: 7911125067 Enrollment ID: I20140902001668 |
| Provider Name | Cynthia See |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1093820565 PECOS PAC ID: 9436252400 Enrollment ID: I20150320000667 |
| Provider Name | Anthonie W Lopez Cortes |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982881199 PECOS PAC ID: 8123318557 Enrollment ID: I20160526000698 |
| Provider Name | Caroline J Schwickerath |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1427344381 PECOS PAC ID: 4789827718 Enrollment ID: I20160803001583 |
| Provider Name | Hannah L Schroeher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063966919 PECOS PAC ID: 5698061026 Enrollment ID: I20160909002048 |
| Provider Name | Lydia K Adams |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1538584131 PECOS PAC ID: 4880827856 Enrollment ID: I20161208000240 |
| Provider Name | Lisa Zittergruen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043446149 PECOS PAC ID: 2668621616 Enrollment ID: I20161228000346 |
| Provider Name | Claire E Haedike |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275843302 PECOS PAC ID: 8123302452 Enrollment ID: I20170303001366 |
| Provider Name | Kent Ingvalson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1861920597 PECOS PAC ID: 5890065841 Enrollment ID: I20170724002961 |
| 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 | Carol L Ludeking |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891211967 PECOS PAC ID: 5294008355 Enrollment ID: I20170912001375 |
| Provider Name | Miranda L Hayek |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1700316254 PECOS PAC ID: 2567724024 Enrollment ID: I20180321000152 |
| Provider Name | Jennessa K Luzum |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1649243544 PECOS PAC ID: 7719879238 Enrollment ID: I20180321000299 |
| Provider Name | Christopher R Cooper |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497015903 PECOS PAC ID: 9931419447 Enrollment ID: I20180321002851 |
| Provider Name | Sarah A Anderson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1518293091 PECOS PAC ID: 6800158270 Enrollment ID: I20180322002239 |
| Provider Name | Andrew J Rix |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1205366671 PECOS PAC ID: 7416219662 Enrollment ID: I20180328000116 |
| Provider Name | Megan A Lyon |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1225568785 PECOS PAC ID: 8729340989 Enrollment ID: I20180328000450 |
| Provider Name | Dennis A Keefe |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1750811212 PECOS PAC ID: 7517220270 Enrollment ID: I20180410001816 |
| Provider Name | Sandy Kay Clayton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578827465 PECOS PAC ID: 4082852751 Enrollment ID: I20180412001626 |
| 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 | Stephen Broski |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1326282112 PECOS PAC ID: 1658566112 Enrollment ID: I20180801002471 |
| Provider Name | Jolanta M Durski |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1407820780 PECOS PAC ID: 5698720472 Enrollment ID: I20180803001923 |
| Provider Name | Douglas A Collins |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1083689483 PECOS PAC ID: 0244257178 Enrollment ID: I20180810001349 |
| Provider Name | Thomas A Foley |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1447220835 PECOS PAC ID: 3072543370 Enrollment ID: I20180813001485 |
| Provider Name | Titus C Evans |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1437137213 PECOS PAC ID: 7214071935 Enrollment ID: I20180817001977 |
| Provider Name | Bryan C Cannon |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1942380373 PECOS PAC ID: 2163592619 Enrollment ID: I20180817002121 |
| Provider Name | Frank Cetta |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1306822549 PECOS PAC ID: 9931008570 Enrollment ID: I20180817002274 |
| Provider Name | Allan Jaffe |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1538146626 PECOS PAC ID: 8426192147 Enrollment ID: I20180823002065 |
| Provider Name | Horng H Chen |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1073599320 PECOS PAC ID: 0941342331 Enrollment ID: I20180824000402 |
| Provider Name | Jeffrey B Geske |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1689878746 PECOS PAC ID: 4789743154 Enrollment ID: I20180824001013 |
| Provider Name | Panithaya Chareonthaitawee |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1730165770 PECOS PAC ID: 6103968474 Enrollment ID: I20180824001799 |
| Provider Name | Jonathan N Johnson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1285648899 PECOS PAC ID: 0446253470 Enrollment ID: I20181002003050 |
| Provider Name | Joerg Herrmann |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1295713253 PECOS PAC ID: 0042232282 Enrollment ID: I20181025000258 |
| Provider Name | Grace Lin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1285608547 PECOS PAC ID: 8426008061 Enrollment ID: I20181025000303 |
| Provider Name | Raul E Espinosa |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1366408106 PECOS PAC ID: 6002876414 Enrollment ID: I20181025000377 |
| Provider Name | Tiffany R Malanaphy |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1649763889 PECOS PAC ID: 0446504021 Enrollment ID: I20181117000440 |
| Provider Name | Scott Pate |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1194161562 PECOS PAC ID: 1153627609 Enrollment ID: I20181203002162 |
| Provider Name | Sarah E Gossett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508105495 PECOS PAC ID: 5193960011 Enrollment ID: I20181213001934 |
| Provider Name | Jason Engelken |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1154802601 PECOS PAC ID: 3072858323 Enrollment ID: I20181214002105 |
| Provider Name | John T Vogel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437411451 PECOS PAC ID: 2466774831 Enrollment ID: I20190214000569 |
| Provider Name | John Jacob Zion Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467017921 PECOS PAC ID: 9133457294 Enrollment ID: I20190827003588 |
| Provider Name | Jennifer M Becker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295380400 PECOS PAC ID: 2062742927 Enrollment ID: I20190919002445 |
| Provider Name | Heather K Levinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215572268 PECOS PAC ID: 3971936618 Enrollment ID: I20191210002562 |
| Provider Name | Joe D Starke |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1053315879 PECOS PAC ID: 8224057484 Enrollment ID: I20191219000179 |
| Provider Name | Eric W Svestka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013203280 PECOS PAC ID: 7911152954 Enrollment ID: I20200331000655 |
| Provider Name | Judd Landers |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1093237646 PECOS PAC ID: 9739519141 Enrollment ID: I20200428000113 |
| Provider Name | Anna Mark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497249098 PECOS PAC ID: 1355698796 Enrollment ID: I20200527002373 |
| Provider Name | Chelsey L Bohr |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336786532 PECOS PAC ID: 6800208943 Enrollment ID: I20201215002077 |
| 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 | Jena Marie Flak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982293726 PECOS PAC ID: 1456767615 Enrollment ID: I20210312001068 |
| Provider Name | Lori Shindelar |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1356922355 PECOS PAC ID: 6901215615 Enrollment ID: I20210511000187 |
| Provider Name | Caitlyn Schultz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285215525 PECOS PAC ID: 5395154835 Enrollment ID: I20210512003068 |
| Provider Name | Emily Elaine Connor |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1992157192 PECOS PAC ID: 2860785813 Enrollment ID: I20210608000309 |
| Provider Name | Kelli Zeimetz-mehmert |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1154990331 PECOS PAC ID: 1951704535 Enrollment ID: I20210720001226 |
| Provider Name | Jami Weinacht |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1992374177 PECOS PAC ID: 6305249996 Enrollment ID: I20210720001708 |
| Provider Name | Ross Avant |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1801275128 PECOS PAC ID: 7719292275 Enrollment ID: I20210903000215 |
| Provider Name | Stacey Quam |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1164003331 PECOS PAC ID: 2062818677 Enrollment ID: I20210908000337 |
| Provider Name | Adam R Miller |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1124407010 PECOS PAC ID: 7618289828 Enrollment ID: I20210913001976 |
| Provider Name | Tarynne Carlson |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134568561 PECOS PAC ID: 0941607428 Enrollment ID: I20210927000667 |
| Provider Name | Amanda Hartley |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1205292950 PECOS PAC ID: 0042617433 Enrollment ID: I20210928001841 |
| Provider Name | Christina Schultz |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1780221986 PECOS PAC ID: 5294133419 Enrollment ID: I20211001001314 |
| Provider Name | Jamie Schneberger |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1194497412 PECOS PAC ID: 9537567151 Enrollment ID: I20211013000921 |
| Provider Name | Ian Chang |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1538451802 PECOS PAC ID: 1153559307 Enrollment ID: I20211109003131 |
| Provider Name | Garvan C Kane |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1346214509 PECOS PAC ID: 0244374965 Enrollment ID: I20211119001349 |
| Provider Name | Benjamin Nordhues |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336555135 PECOS PAC ID: 4082830666 Enrollment ID: I20211207000115 |
| Provider Name | Jacob Jentzer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538334628 PECOS PAC ID: 2567782261 Enrollment ID: I20211214001689 |
| Provider Name | Sarah J Otterness |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1639765548 PECOS PAC ID: 7416364849 Enrollment ID: I20220215000477 |
| Provider Name | Hayan Jouni |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1417278987 PECOS PAC ID: 7911155130 Enrollment ID: I20220330000371 |
| Provider Name | Thomas C Gerber |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538156799 PECOS PAC ID: 5698803500 Enrollment ID: I20220418001639 |
| Provider Name | Sarah F Wicks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174174932 PECOS PAC ID: 2062894728 Enrollment ID: I20220728000742 |
| Provider Name | Darren G Hyams |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699186767 PECOS PAC ID: 6901142769 Enrollment ID: I20220801001564 |
| Provider Name | Jessica Marie Hyams |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154732253 PECOS PAC ID: 1951647718 Enrollment ID: I20221217000139 |
| Provider Name | Jeremy Thaden |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1295996296 PECOS PAC ID: 3971771577 Enrollment ID: I20230303001281 |
| Provider Name | Rebecca K Ameduri |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861696569 PECOS PAC ID: 4688728116 Enrollment ID: I20230306000907 |
| Provider Name | Hector Michelena |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1861469744 PECOS PAC ID: 4688689300 Enrollment ID: I20230306001700 |
| Provider Name | Corrie R Bach |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023403672 PECOS PAC ID: 7719292093 Enrollment ID: I20230310000806 |
| Provider Name | Jared G Bird |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1467898155 PECOS PAC ID: 9931341534 Enrollment ID: I20230311000122 |
| Provider Name | Michael W Cullen |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1568589174 PECOS PAC ID: 2264523075 Enrollment ID: I20230315000713 |
| Provider Name | Tyler J Peterson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1639328784 PECOS PAC ID: 7517081870 Enrollment ID: I20230322000391 |
| Provider Name | Kathleen A Young |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1184003089 PECOS PAC ID: 0042521700 Enrollment ID: I20230424001865 |
| Provider Name | Dominick A Siconolfi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255823415 PECOS PAC ID: 6709295314 Enrollment ID: I20230522000221 |
| Provider Name | Ayse Karagulle Kendi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235358615 PECOS PAC ID: 3779644166 Enrollment ID: I20230605001629 |
| Provider Name | Paul Mckie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104945336 PECOS PAC ID: 8820181217 Enrollment ID: I20230622000717 |
| Provider Name | John P Frawley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1124649900 PECOS PAC ID: 9335570811 Enrollment ID: I20230727003365 |
| Provider Name | Michael D'netto |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1538666839 PECOS PAC ID: 8022365824 Enrollment ID: I20230728001331 |
| Provider Name | Hannah Ingvalson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588284707 PECOS PAC ID: 7911368071 Enrollment ID: I20230804002921 |
| Provider Name | Jennifer M Schrandt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346951332 PECOS PAC ID: 5193199917 Enrollment ID: I20230821003527 |
| Provider Name | Bryan Byerly |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1578059234 PECOS PAC ID: 5395108344 Enrollment ID: I20230824000962 |
| Provider Name | Mark Ballard |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1801909718 PECOS PAC ID: 7012821721 Enrollment ID: I20231007000637 |
| Provider Name | Arin Deering |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548975014 PECOS PAC ID: 5991170805 Enrollment ID: I20231031001216 |
| Provider Name | Timothy Morgenthaler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043282585 PECOS PAC ID: 3779664420 Enrollment ID: I20231116000251 |
| Provider Name | Kara Renee Crain |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740432855 PECOS PAC ID: 3476902842 Enrollment ID: I20231211001454 |
| Provider Name | Gregory Wiseman |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1205816329 PECOS PAC ID: 9537203534 Enrollment ID: I20240612000393 |
| Provider Name | Brittanee Samuelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891323499 PECOS PAC ID: 2365843588 Enrollment ID: I20240614000226 |
| Provider Name | Aleczander C Battelle |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1902478795 PECOS PAC ID: 9537604566 Enrollment ID: I20240713000323 |
| Provider Name | Siva Mulpuru |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770740417 PECOS PAC ID: 4284880352 Enrollment ID: I20240730000973 |
| Provider Name | Cassandra Marie Quam |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194330167 PECOS PAC ID: 3870912454 Enrollment ID: I20241001001542 |
| Provider Name | Abhishek Deshmukh |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1538359906 PECOS PAC ID: 8325262454 Enrollment ID: I20241010002713 |
| Provider Name | Larry Binkovitz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801834775 PECOS PAC ID: 4284725326 Enrollment ID: I20241017001625 |
| Provider Name | John W Askew |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1568436632 PECOS PAC ID: 2567494073 Enrollment ID: I20241107001020 |
| Provider Name | Hector Villarraga |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1376562546 PECOS PAC ID: 1658260567 Enrollment ID: I20241107001023 |
| Provider Name | Rowlens Melduni |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1285614362 PECOS PAC ID: 8325074073 Enrollment ID: I20241108000263 |
Gundersen Regional Clinics Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1830 State Highway 9 Ste 100, Decorah, IA 52101 Phone: 608-782-7300 | |
Family Care Clinic Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 903 Commerce Dr, Decorah, IA 52101 Phone: 563-382-1200 Fax: 563-382-1211 | |