Provider Type Icon

CONVENIENT CARE MEDICAL GROUP PLLC NPI 1336523893


NPI Information

NPI: 1336523893
Provider Name: CONVENIENT CARE MEDICAL GROUP, PLLC
Classification: Physician Assistant - 363A00000X
Entity Type: Organization

CLIA Number: 16D2056897

Address:
3502 METRO DRIVE
SUITE 200
COUNCIL BLUFFS, IA
ZIP 51501
Phone: (712) 256-7172
Get Directions

CONVENIENT CARE MEDICAL GROUP, PLLC is a physician assistant in Council Bluffs, IA. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. CONVENIENT CARE MEDICAL GROUP, PLLC NPI is 1336523893. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3502 METRO DRIVE
SUITE 200
COUNCIL BLUFFS, IA
ZIP 51501-724
Phone: (712) 256-7172
Fax: (712) 256-7374

The provider's authorized official is Wyatt Allen Schmidt .
The authorized official title is Physicain Assistant/manager and has the following contact phone number (712) 256-7172.

The CLIA number assigned to this NPI record is 16D2056897 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/15/2015 and was last updated on 10/2/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363L00000XNurse PractitionerA121973IOWANo
2363A00000XPhysician Assistant002355IOWAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.