MR. BRETT BODDICKER (NPI# 1588105597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588105597 |
| Entity Type | Individual |
| Full Name | MR. BRETT BODDICKER |
| Practice Address |
812 University Street Pella IA 50219 |
| Mailing Address |
812 University St Pella IA 50219-1902 |
| Practice Telephone | 3192135124 |
| Mailing Telephone | 3192135124 |
| Enumeration Date | 2017-03-10 |
| Last Update Date | 2017-03-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | 3727 | IA | Student, Health Care |
| Street Address |
812 UNIVERSITY STREET |
| City | PELLA |
| State | IA |
| Zip Code | 50219 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366967101 | Emily Rachel Dine | Specialist/Technologist | 812 University, Pella, IA 50219 | 2017-08-12 |
| 1053780098 | Jeremy Richard Dolder | Specialist/Technologist | 812 University St., Pella, IA 50219 | 2015-09-21 |
| 1588921084 | Michael Gary Walsh | Psychiatry & Neurology | 710 W 1st St, Pella, IA 50219 | 2012-04-20 |
| 1063788602 | Multicultural International Counseling Enterprises, Inc. | Psychologist | 311 Franklin Street, Pella, IA 50219 | 2012-03-28 |
| 1568798056 | Megan Lee Nelson | Physical Therapist | 405 Monroe Street, Pella, IA 50219 | 2009-10-19 |
| 1578783247 | Suzanne Vonseggern | Pharmacist | 1610 Vemeer Rd, East Plant 3, Pella, IA 50219 | 2007-04-26 |
| 1669513057 | Heather Renee Pilcher | Physical Therapy Assistant | 308 Se 9th St., Pella, IA 50219 | 2007-02-09 |
| 1164578134 | Walgreen Co. | Pharmacy | 1610 Vermeer Road East, Plant 3 1/2, Pella, IA 50219 | 2007-01-25 |
| 1841373289 | Jeffrey Frank Allen | Dentist | 839 Broadway, Pella, IA 50219 | 2006-10-21 |
| 1790708451 | Michael M Mccubbin | Allergy & Immunology | 1108 Washington Street, Pella, IA 50219 | 2006-07-25 |
| Find all providers in zip 50219 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518503911 | Aspen Clark | Student in an Organized Health Care Education/Training Program | 812 University St # 295, Pella, IA 50219-1902 | 2019-11-20 |
| 1407466980 | Rylee Powell | Student in an Organized Health Care Education/Training Program | 812 University St, Pella, IA 50219-1902 | 2020-08-09 |
| 1538779004 | Luke B Pavlat | Student in an Organized Health Care Education/Training Program | 812 University St, Pella, IA 50219-1999 | 2020-08-08 |
| 1720698921 | Nicole M May | Student in an Organized Health Care Education/Training Program | 812 University St, Pella, IA 50219-1902 | 2020-08-03 |
| 1326526831 | Jordan Alton Borman | Student in an Organized Health Care Education/Training Program | 812 University St, Pella, IA 50219-1902 | 2018-08-06 |
| 1144708652 | Jake Johnson | Student in an Organized Health Care Education/Training Program | 812 University St, Pella, IA 50219-1902 | 2018-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750908836 | Sarahi Casillas | Student in an Organized Health Care Education/Training Program | 5705 Nw 57th Ave, Johnston, IA 50131-1437 | 2020-07-06 |
| 1437773124 | Laura Christ | Student in an Organized Health Care Education/Training Program | 2435 Se 12th St, West Des Moines, IA 50265-8547 | 2020-05-29 |
| 1558981001 | Townsen G Kennington | Student in an Organized Health Care Education/Training Program | 1720 E Lacona Ave, Des Moines, IA 50320-1166 | 2020-04-24 |
| 1841810645 | Brenda J Lugo | Student in an Organized Health Care Education/Training Program | 810 Pierce St, Iowa Falls, IA 50126-1417 | 2020-04-21 |
| 1528687332 | Allison Baumhover | Student in an Organized Health Care Education/Training Program | 13556 Mahogany Ave, Carroll, IA 51401-8849 | 2020-04-11 |
| 1811526502 | Armin Avdic | Student in an Organized Health Care Education/Training Program | 820 Olde Macabe Cir, Coralville, IA 52241-1780 | 2020-04-03 |
| 1013545722 | Abby Lee Rewoldt | Student in an Organized Health Care Education/Training Program | 339 Teeters Ct, Iowa City, IA 52246-3839 | 2020-03-29 |
| 1942837976 | Devon Anderson | Student in an Organized Health Care Education/Training Program | Des Moines University Pa Program, 3200 Grand, Des Moines, IA 50312 | 2020-03-27 |
| 1578190583 | Christian Ostrander | Student in an Organized Health Care Education/Training Program | Des Moines University-pa Program 3200 Grand Avenue, Des Moines, IA 50312 | 2020-03-27 |
| 1104453752 | Michael Sarris | Student in an Organized Health Care Education/Training Program | 3200 Grand Ave # D, Des Moines, IA 50312-4104 | 2020-03-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.