1972573145 NPI number — ULTIMATE NURSING SERVICES OF IOWA, LLC

Table of content: (NPI 1972573145)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972573145 NPI number — ULTIMATE NURSING SERVICES OF IOWA, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ULTIMATE NURSING SERVICES OF IOWA, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972573145
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/24/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3345 106TH CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
URBANDALE
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50322-3740
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
515-280-2160
Provider Business Mailing Address Fax Number:
866-422-5272

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3345 106TH CIR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
URBANDALE
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50322-3740
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-280-2160
Provider Business Practice Location Address Fax Number:
866-422-5272
Provider Enumeration Date:
01/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DE JESUS
Authorized Official First Name:
EMMA
Authorized Official Middle Name:
Authorized Official Title or Position:
CREDENTIALING DIRECTOR
Authorized Official Telephone Number:
813-850-0042

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 167328 . This is a "MEDICARE OSCAR/CERTIFICATION" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 0672493 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0706429 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 167249 . This is a "MEDICARE OSCAR/CERTIFICATION" identifier . This identifiers is of the category "OTHER".
  • Identifier: 167325 . This is a "MEDICARE OSCAR/CERTIFICATION" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 0670003 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 167325 . This is a "MEDICARE ID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 167325 . This is a "MEDICARE OSCAR/CERTIFICATION" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0670004 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".




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