Clinic Zip By First Participant Code Name City … folder/a... · audubon Audubon Family Healthcare...
Transcript of Clinic Zip By First Participant Code Name City … folder/a... · audubon Audubon Family Healthcare...
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Adams Prior Authorization 601 Rosary Drive Corning 50841 Brittany Corning Adams
Closed -
Unreacha
ble
Allamakee Prior Authorization 105 E Main St Waukon 52172 Ben Postville Allamakee
Closed -
Intake
Only
Appanoose
Mercy Medical Clinic
Centerville 19876 St Joseph Dr Centerville 52544 Carol Centerville Appanoose
Closed -
Enrolled
appanoose Prior Authorization 10109 Maple Street Omaha 68134 Misty Council Bluffs
Pottawatta
mie
Closed -
Enrolled
Appanoose Prior Authorization 19876 St Joseph Centerville Cassie Centerville Appanoose
Closed -
Unreacha
ble
audubon Audubon Family Healthcare 50025 Anissa Audubon Audubon
Closed -
Unreacha
ble
audubon
Audubon Family Healthcare
Clinic 50025
Christophe
r Audubon Audubon
Closed -
Unreacha
ble
Blackhawk Covenant Clinic 50702 Suba Waterloo Black Hawk
Closed -
Declined
Blackhawk Covenant Clinic Suba Waterloo Black Hawk
Closed -
Unreacha
ble
BlackHawk Covenant Medical Center 50702 Unknown Waterloo Black Hawk
Closed -
Unreacha
ble
Blackhawk
COVENANT MIDWIVES &
WOMEN'S HEALTH
Closed -
Invalid
Blackhawk Family Medicine Waterloo Waterloo Black Hawk
Closed -
Enrolled
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Blackhawk Family Medicine Waterloo Martha Waterloo Black Hawk
Closed -
Already
Participati
ng
Blackhawk
Family Medicine Waterloo
Unity Point Clinic 50703 Suzanne Independence Buchanan
Closed -
Unreacha
ble
Blackhawk
Family Medicine Waterloo
UnityPoint Clinic 50703
Martha
Hall /
Timothy Waterloo Black Hawk
Closed -
Duplicate
Blackhawk FM waterloo TIm Waterloo Black Hawk
Closed -
Enrolled
BlackHawk Greenhill 1015 S Hackett Rd Waterloo 50701 Meredith Waterloo Black Hawk
Closed -
Enrolled
BlackHawk Partners in Ob/Gyn 50702 Karla Waterloo Black Hawk
Closed -
Duplicate
BlackHawk
People Community Health
Clinic 50703 Kiran Waterloo Black Hawk
Closed -
Intake
Only
BlackHawk
PEOPLES COMMUITY
HEALTH CLINIC KIRAN Waterloo Black Hawk
Closed -
Unreacha
ble
BlackHawk
Peoples Community Health
Clinic 905 Franklin st Waterloo 50703 Waterloo Black Hawk
Closed -
Unreacha
ble
BlackHawk
Peoples Community Health
Clinic 50703 Emily Waterloo Black Hawk
Closed -
Declined
BlackHawk
Peoples Community Health
Clinic Heidi Evansdale Black Hawk
Closed -
Enrolled
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
BlackHawk
PEOPLES COMMUNITY
HEALTH CLINIC EMILY Waterloo Black Hawk
Closed -
Enrolled
BlackHawk
Peoples Community Health
Clinic 50703 Sarah Waterloo Black Hawk
Closed -
Enrolled
BlackHawk Prior Authorization
2055 Kimball Ave Ste
400 Waterloo 50702 Mitchel Waterloo Black Hawk
Closed -
Intake
Only
BlackHawk Prior Authorization 3562 Lafayette Road Evansdale 50707 Tammy Evansdale Black Hawk
Closed -
Unreacha
ble
BlackHawk Prior Authorization 3562 Lafayette Rd Evansdale 50707 Tammy Evansdale Black Hawk
Closed -
Unreacha
ble
BlackHawk Prior Authorization 601 Highway 218 N Troy La Porte City Black Hawk
Closed -
Enrolled
Boone
Boone County Comp
Specialty 50036 Tracey Coon Rapids Carroll
Closed -
Unreacha
ble
Boone
BOONE COUNTY
COMPREHENSIVE
SPECIALTY CLINIC 564 K AVENUE BOONE 50036 DR. Boone Boone
Closed -
Unreacha
ble
Boone
Boone County
Comprehensive Specialty
Clinic 50036 Dr Boone Boone
Closed -
Duplicate
Boone
Comprehensive Specialty
Care
1015 Union St Suite
120 Boone 50036 Tracy
Closed -
Unreacha
ble
Bremer Waverly Health Center Tripoli Bremer
Closed -
Unreacha
ble
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Bremer
Waverly Health Center-
Women's Clinic Ann Nashua Chickasaw
Closed -
Unreacha
ble
Buchanan Prior Authorization 1094 220th Street Jesup 50648 Mark Independence Buchanan
Closed -
Declined
Butler
People's Clinic Butler
County 50619 Courtney Clarksville Butler
Closed -
Unreacha
ble
Butler Prior Authorization 502 3rd Street Parkersburg 50665 Gina
Closed -
Enrolled
Carroll Iowa Heart Center 405 S Clark St Carroll 51401 Suzanne Lake City Calhoun
Closed -
Enrolled
Carroll Prior Authorization
515 North Main
Street Carroll 51401 Linda Carroll Carroll
Closed -
Invalid
cerro gordo Prior Authorization
1010 4th Street SW,
Suite 340 Mason City Jasjit
Closed -
Intake
Only
CerroGordo Iowa Specialty Hospital 50421 Dennis Belmond Wright
Closed -
Enrolled
CerroGordo Iowa Specialty Hospital Dennis Belmond Wright
Closed -
Enrolled
CerroGordo Mercy Interrnal Medicine 50401 Lisa Mason City
Cerro
Gordo
Closed -
Enrolled
CerroGordo
Mercy Medical Center
North Iowa 1000 4th St SW Mason City 50401 Ameen Charles City Floyd
Closed -
Enrolled
CerroGordo Prior Authorization
1010 4th st sw suite
340 Mason City 50401 Jasjit Mason City
Cerro
Gordo
Closed -
Unreacha
ble
CerroGordo Prior Authorization 1010 4th St Suite 240 Mason City 50401 Denul Mason City
Cerro
Gordo
Closed -
Invalid
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Cherokee Cherokee Regional Clinic 300 Soiux Valley Dr Cherokee 51012 Rebecca Holstein
Closed -
Unreacha
ble
Cherokee Cherokee Regional Clinic 300 Sioux Valley Dr Cherokee 51012 Chris Cherokee
Closed -
Intake
Only
Cherokee Cherokee Regional Clinic 300 Sioux Valley Dr Cherokee 51012 Brenda Cherokee
Closed -
Declined
Cherokee Prior Authorization 300 Sioux Valley Dr Cherokee 51012
Christophe
r Cherokee Cherokee
Closed -
Enrolled
clay
Avera Medical Group
Spencer 51301 Jeffrey Spencer Clay
Closed -
Declined
Clay Prior Authorization 337 11th Street SW Spencer Kathryn Sibley Osceola
Closed -
Already
Participati
ng
Clayton Prior Authorization 200 Main Guttenberg 52052 Michele Mc Gregor Clayton
Closed -
Enrolled
clayton Regional Family Health 702 W Union St Edgewood Scot Independence Buchanan
Closed -
Enrolled
Clinton Community Health Care 52732 Ashley Clinton Clinton
Closed -
Unreacha
ble
Clinton Community Health Care 52732 Ashley Clinton Clinton
Closed -
Duplicate
Clinton Dr Osaro Clinton Clinton
Closed -
Enrolled
Clinton MMc-C 52732 Delmar Clinton
Closed -
Unreacha
ble
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Clinton MMc-C Clinton Clinton
Closed -
Unreacha
ble
Clinton MMc-C Camanche Clinton
Closed -
Enrolled
Clinton Prior Authorization 507 South 4th Street Clinton 52732 Mona Clinton Clinton
Closed -
Unreacha
ble
Clinton Prior Authorization
915 13th Avenue
North Clinton 52732 Thersa Clinton Clinton
Closed -
Invalid
Dallas Mercy Clinic Perry Steven Woodward Dallas
Closed -
Declined
Dallas Merry Clinic Perry Perry 50220 Steven Perry Dallas
Closed -
Enrolled
Dallas MMC ADEL 1120 Greene St Adel 50003
Christophe
r Adel Dallas
Closed -
Enrolled
Dallas Prior Authorization
30 East Hickman
Road Waukee 50263 Hanna Waukee Dallas
Closed -
Enrolled
Dallas Prior Authorization 30 E Hickman Rd Waukee 50263 Jenna
West Des
Moines Polk
Closed -
Ineligible
Decatur
Community Health Centers
of Southern Iowa 302 NW 14th St Leon 50144 Jennifer Leon Decatur
Closed -
Unreacha
ble
Decatur Prior Authorization 302 NE 14th Street Leon 50144 Nathan Garden Grove Decatur
Closed -
Unreacha
ble
Des Moines BAFP
1225 S Gear Ave Ste
159 W Burl Lisa Burlington
Des
Moines
Closed -
Unreacha
ble
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Des Moines
COMMUNITY HEALTH
CENTER 52655 Rebecca Burlington
Des
Moines
Closed -
Unreacha
ble
Des Moines Community Health Center Burlington
Des
Moines
Closed -
Enrolled
Des Moines
COMMUNITY HEALTH
CENTER SE IA
Closed -
Invalid
Des Moines
Community Health Center
Southeast Iowa 52655
DR
TIMOTHY
Closed -
Intake
Only
Des Moines Great River Medical Center Wapello Louisa
Closed -
Unreacha
ble
Des Moines
Great River Medical Center -
Resp Care Dr
West
Burlington
Des
Moines
Closed -
Declined
Des Moines
Great River Medical Center -
Respiratory Care 52655 Dr Burlington
Des
Moines
Closed -
Unreacha
ble
DesMoines Prior Authorization 1225 S Gear Ave
West
Burlington 52655 Keokuk Lee
Closed -
Unreacha
ble
Douglas Prior Authorization 10109 Maple Street Omaha 68134 Misty Council Bluffs
Pottawatta
mie
Closed -
Enrolled
Dubuque Care for Yourself 52001
Visiting
Nurse
Association Dubuque Dubuque
Closed -
Unreacha
ble
Dubuque Care For Yourself Lori Sioux City Woodbury
Closed -
Unreacha
ble
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Dubuque Care For Yourself Waterloo Black Hawk
Closed -
Unreacha
ble
Dubuque MEDICAL ASSOCIATES 52001 DR RYAN Dubuque Dubuque
Closed -
Enrolled
Dubuque Medical Associates 52001 Sara Dubuque Dubuque
Closed -
Unreacha
ble
Dubuque Medical Associates 52060 Eric Maquoketa Jackson
Closed -
Ineligible
Dubuque
Medical Associates Family
Medicine Sara Dubuque Dubuque
Closed -
Already
Participati
ng
Dubuque
Unity Point Clinic Finley
Cardiology
350 North
Grandview Ave Suite
G3300 Dubuque 52001 Tauseef Dubuque Dubuque
Closed -
Unreacha
ble
Dubuque
Unity Point Clinic Finley
Cardiology
350 North
Grandview Ave Suite
G3300 Dubuque 52001 Tauseef Dubuque Dubuque
Closed -
Enrolled
Fayette Covenant Clinic 50662 Gayla Fairbank Buchanan
Closed -
Unreacha
ble
Fayette COVENANT CLINIC 50662 Gayla
Closed -
Declined
Fayette Prior Authorization 129 8th Avenue SE Oelwein 50662 Nasredin Oelwein Fayette
Closed -
Enrolled
Floyd Prior Authorization 1501 S Main St Ste 1 Charles City 50616 David Charles City Floyd
Closed -
Unreacha
ble
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Franklin MCRHC Osage Clinic 620 N 8th st Osage 50431 Mark Osage Mitchell
Closed -
Duplicate
greene
Greene Family Clinic -
Mercy 50636 Patricia Greene Butler
Closed -
Declined
greene
Greene Family Clinic -
Mercy 50636 Patricia Greene Butler
Closed -
Declined
Guthrie GCH Clinic Michael Stuart Guthrie
Closed -
Enrolled
Guthrie GCH Clinic Stuart 50250 Michael Stuart Guthrie
Closed -
Already
Participati
ng
Guthrie GCH Clinics 50216 Josh Panora Guthrie
Closed -
Unreacha
ble
Hamilton Vandiest Family Clinic 50595 Nicole Jewell Hamilton
Closed -
Unreacha
ble
Hamilton Vandiest Family Clinic 2350 Hospital Dr 50595 Kathryn Webster City Hamilton
Closed -
Unreacha
ble
Hardin Iowa Falls Clinic 50126 Erin Hampton Franklin
Closed -
Intake
Only
Hardin McFarland Clinic 7413 Eddington Ave Eldora 50627 Abigal Eldora Hardin
Closed -
Enrolled
Hardin McFarland Clinic Eldora 50627 Aaron Eldora Hardin
Closed -
Duplicate
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Hardin Prior Authorization 920 South Oak Street Iowa Falls 50126 Sarah Coulter Franklin
Closed -
Unreacha
ble
Hardin Prior Authorization 2413 Edginton Ave Eldora 50627 Aaron Eldora Hardin
Closed -
Ineligible
harrison CHI Logan 51546 Carrie Logan Harrison
Closed -
Enrolled
harrison CHi Logan 51546 Carrie Logan Harrison
Closed -
Already
Participati
ng
harrison CHI Logan 51546 Nathaniel Logan Harrison
Closed -
Already
Participati
ng
harrison CHI Logan 51546 Nathaniel Logan Harrison
Closed -
Enrolled
Howard Cresco Medical Clinic 52136 Tracey Elma Howard
Closed -
Duplicate
Howard CVESCO Medical Clinic 52136 Tracey Elma Howard
Closed -
Unreacha
ble
Howard Prior Authorization
321 8th Avenue
West Cresco 52136 Jessica Cresco Howard
Closed -
Enrolled
Iowa
Williamsburg Family
Medical Clinic 498 N Highland St
Williamsbur
g 52361 Michelle Brooklyn Poweshiek
Closed -
Enrolled
Iowa
Williamsburg Family
Medical Clinic 498 N Highland St
Williamsbur
g 52361 mICHELLE Deep River Poweshiek
Closed -
Enrolled
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
jackson Maquokita Family Clinic 52060 Alyssa Maquoketa Jackson
Closed -
Declined
Jasper Newton Clinic, PC
300 North 4th
Avenue East, Suite
200 Newton 50208 Ty Marshalltown Marshall
Closed -
Unreacha
ble
Jasper Newton Clinic, PC
300 North 4th
Avenue East, Suite
200 Newton 50208 Stephanie Newton Jasper
Closed -
Ineligible
Johnson
Dental Special Geriatric
Dept 322 Dental Science Iowa CIty 52242 Eldridge Scott
Closed -
Enrolled
Johnson Family Medicine 200 Hawkins Dr Iowa City 52242 Brigit West Branch Cedar
Closed -
Unreacha
ble
Johnson
Family Medicine Iowa River
Landing East 52241 Hussain Goose Lake Clinton
Closed -
Intake
Only
Johnson
Family Medicine Iowa River
Landing East 52241 Hussain Goose Lake Clinton
Closed -
Duplicate
Johnson HYVEE Pharm Albia
UI Womens Hlth 200
Hawkins Dr Iowa City Eugenia Albia Monroe
Closed -
Intake
Only
Johnson
IA River Landing East Family
Med Kathleen Iowa City Johnson
Closed -
Unreacha
ble
Johnson Internal Medicine 200 Hawkins Dr Iowa City 52242 Jason Cedar Falls Black Hawk
Closed -
Unreacha
ble
Johnson
Iowa River Landing East
Family Medicine 52241 Shalina Keokuk Lee
Closed -
Unreacha
ble
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Johnson IRL East Family Medicine Shalina Bennett Cedar
Closed -
Unreacha
ble
Johnson
Johnson County Public
Health Iowa City Johnson
Closed -
Unreacha
ble
Johnson
Periodontics Clinic
Univeristy of IA 52242 Davenport Scott
Closed -
Unreacha
ble
Johnson Prior Authorization 1130 S Scott Blvd Iowa City 52240 Matthew Iowa City Johnson
Closed -
Unreacha
ble
Johnson Prior Authorization 200 Hawkins Drive Iowa City 52243 Margaret Cedar Rapids Linn
Closed -
Intake
Only
Johnson Prior Authorization 1067 Ryan Court Iowa City 52246 Mei Iowa City Johnson
Closed -
Unreacha
ble
Johnson Prior Authorization 3 Lions Dr N Liberty 52317 Angela North Liberty Johnson
Closed -
Declined
Johnson Prior Authorization 1765 Lininger Lane
North
Liberty Vincent Cedar Rapids Linn
Closed -
Already
Participati
ng
Johnson UIHC 200 HAWKINS DR IOWA CITY 52242
Closed -
Unreacha
ble
Johnson UIHC - Family Medicine 200 Hawkins Drive Iowa City 52242 Garrett Iowa City Johnson
Closed -
Enrolled
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Johnson UIHC Family Med 200 Hawkins Dr Iowa city 52242 Elora North English Iowa
Closed -
Unreacha
ble
Johnson
University of Iowa Hospitals
& Clinics 200 Hawkins Dr Iowa City 52242 Sara Casey Guthrie
Closed -
Unreacha
ble
Jones Prior Authorization 1791 Hwy 64 E Anamosa 52205 Alissa Tipton Cedar
Closed -
Unreacha
ble
Keokuk KCHC Medical Clinic 1314 Stuart Sigourney 52591 Shelly What Cheer Keokuk
Closed -
Enrolled
Kossuth
Kossuth Regional Health
Center Algona Kossuth
Closed -
Intake
Only
Linn Abbe Center 520 11th Street NW
Cedar
Rapids 52405 Ellen Hiawatha
Closed -
Enrolled
Linn
Bowman Woods Family
Practice Teresa Cedar Rapids Linn
Closed -
Unreacha
ble
Linn
EASTER IOWA HEALTH
CENTER
Closed -
Unreacha
ble
Linn Eastern IA Health Center Bradley Cedar Rapids Linn
Closed -
Unreacha
ble
Linn Eastern IA Health Center Ursula Cedar Rapids Linn
Closed -
Intake
Only
Linn Eastern IA Health Center Anamosa Jones
Closed -
Enrolled
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Linn Eastern Iowa Health Center 52402 Cedar Rapids Linn
Closed -
Duplicate
Linn Eastern Iowa Health Center 52403 Ramya Marion Linn
Closed -
Unreacha
ble
Linn Eastern Iowa Health Center 52403 Ramya Cedar Rapids Linn
Closed -
Unreacha
ble
Linn Eastern Iowa Health Center CEDAR RAPIDS Linn
Closed -
Unreacha
ble
Linn
EASTERN IOWA HOME
HEALTH CARE 52310 Anamosa Jones
Closed -
Duplicate
Linn
EIHC Eastern Iowa Health
Center Prachi Cedar Rapids Linn
Closed -
Unreacha
ble
Linn Mercy Care Vernon Village
3933 Mt Vernon Rd
SE
Cedar
Rapids 52403 Ann Cedar Rapids Linn
Closed -
Declined
Linn
Mercycare Community
Physicians
600 7th St SE Suite
101
Cedar
Rapids 52401 Monica Cedar Rapids Linn
Closed -
Unreacha
ble
Linn Monica Meeker
600 7th Street SE,
Suite 101
Cedar
Rapids 52401 Monica Cedar Rapids Linn
Closed -
Enrolled
Linn Prior Authorization 200 Virgil Ave Mt Vernon 52314 Ben Marion Linn
Closed -
Unreacha
ble
Linn Prior Authorization
600 7th Street SE,
Suite 101
Cedar
Rapids 52401 Monica Cedar Rapids Linn
Closed -
Unreacha
ble
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Linn Prior Authorization 855 A Ave NE #200
Cedar
Rapids 52402 Kristy Cedar Rapids Linn
Closed -
Unreacha
ble
Linn Prior Authorization 1444 2 Ave SE
Cedar
Rapids 52403 Merrilee Cedar Rapids Linn
Closed -
Enrolled
Linn Prior Authorization 830 4th Ave 8E Ste 1
Cedar
Rapids 52404 Ciek Marion Linn
Closed -
Declined
Linn Prior Authorization
9255 Atlantic Drive
SW
Cedar
Rapids Michelle Cedar Rapids Linn
Closed -
Invalid
Linn
Unity Point Clinic Marion
Family Medicine 52302 Jessica Marion Linn
Closed -
Unreacha
ble
Linn
Unity Point Westside Family
Medicince 52404 Cedar Rapids Linn
Closed -
Enrolled
Linn
UNITY POINT WESTSIDE
FAMILY MEDICINE 52404
DR
ANSHUL Toledo Tama
Closed -
Unreacha
ble
Linn
UnityPoint Multi-Specialty
Clinic 52402
Muhamma
d Cedar Rapids Linn
Closed -
Unreacha
ble
Linn
Westside Family Medicine
and Urgent Care Cedar Rapids Linn
Closed -
Enrolled
Lucas Prior Authorization
1200 North 7th
Street Chariton 50049 Phillip Chariton Lucas
Closed -
Intake
Only
Lyon Sanford Clinic Rock Rapids
803 South Green
Street Rock Rapids 51246 Beta Rock Rapids Lyon
Closed -
Already
Participati
ng
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Lyon Sanford Clinic Rock Rapids 51246 Rebecca Doon Lyon
Closed -
Unreacha
ble
Lyon
SANFORD CLINIC ROCK
RAPIDS
Closed -
Ineligible
Mahaska Plumpod 1229 C Ave East Tonya
University
Park Mahaska
Closed -
Enrolled
Mahaska Prior Authorization 1229 C Ave E Oskaloosa 52577 Jen Redfield Dallas
Closed -
Declined
Mahaska Prior Authorization 1229 C Ave E Oskaloosa 52577 T Oskaloosa Mahaska
Closed -
Unreacha
ble
mahaska Prior Authorization 1229 C Ave Oskaloosa Eric Oskaloosa Mahaska
Closed -
Unreacha
ble
Marshall
CENTERAL IOWA
HEALTHCARE-STATE
CENTER CLINIC 50247 Amanda Marshalltown Marshall
Closed -
Declined
Marshall mcfarland clinic meagan Marshalltown Marshall
Closed -
Unreacha
ble
Marshall Primary Health Care 50158 Becky Marshalltown Marshall
Closed -
Enrolled
Marshall Primary Health Care Tim
MARSHALLTO
WN Marshall
Closed -
Unreacha
ble
Marshall PRIMARY HEALTH CARE DEBORAH Marshalltown Marshall
Closed -
Ineligible
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Marshall Primary Health Care Unknow Gilman Marshall
Closed -
Unreacha
ble
Marshall Prior Authorization 303 Nicholas Drive
Marshalltow
n 50158 Maria Marshalltown Marshall
Closed -
Declined
Minnehaha AVERA MEDICAL GROUP
1301 S CLIFF AVE STE
601 SIOUX FALLS 57105 DR Terril Dickinson
Closed -
Enrolled
minnesota DIAB 56267 Cathy Burlington
Des
Moines
Closed -
Declined
minnesota MAYO CLINIC 55905 DR Farmersburg Clayton
Closed -
Unreacha
ble
Mitchell Prior Authorization 620 North 8th Street Osage 50461 Mark Osage Mitchell
Closed -
Enrolled
monona
BARGESS FAMILY CLINIC-
MAPLE VALLEY 51034 CHAD Ute Monona
Closed -
Duplicate
monona
Burgess Family Clinic-Maple
Valley 51034 Chad Ute Monona
Closed -
Enrolled
montgomer
y
Villioca Family Health
Center 50864 Tom Clarinda Page
Closed -
Unreacha
ble
montgomer
y
Villisca Family Health
Center 50864 Effie Stanton
Montgome
ry
Closed -
Enrolled
montgomer
y
VILLISCA FAMILY HEALTH
CENTER
Closed -
Ineligible
Muscatine Prior Authorization 1518 Mulberry Ave Muscatine Muscatine Muscatine
Closed -
Intake
Only
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Muscatine UI Healthcare Muscatine Christina Muscatine Muscatine
Closed -
Unreacha
ble
Not
Available
Atkins Family Medical
Center Stephanie Cedar Rapids Linn
Closed -
Unreacha
ble
Not
Available Avera Medical Grp Anthony Estherville Emmet
Closed -
Unreacha
ble
Not
Available CHC Naarah Burlington
Des
Moines
Closed -
Declined
Not
Available CHC Naarah Burlington
Des
Moines
Closed -
Declined
Not
Available COMMUNNITY HEALTH CTR
Closed -
Duplicate
Not
Available FAM MED
Closed -
Ineligible
Not
Available FAMILY MEDICINE CLINIC 51040
Closed -
Enrolled
Not
Available Family Medicine Clinic Dr Sioux City Woodbury
Closed -
Ineligible
Not
Available Health System Luana Clayton
Closed -
Unreacha
ble
Not
Available
Internal Med Central
Campus Michael
Closed -
Unreacha
ble
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Not
Available McFarland Clinic Jefferson Greene
Closed -
Enrolled
Not
Available Mercy Care Jerry Tama Tama
Closed -
Enrolled
Not
Available MERCY EAST VILLAGE
Closed -
Enrolled
Not
Available Mercy Family Care Jason Perry Dallas
Closed -
Enrolled
Not
Available Mercy Family Care-Perry Jason Polk City Polk
Closed -
Unreacha
ble
Not
Available Mercy Medical Center Clinton Clinton
Closed -
Already
Participati
ng
Not
Available Mercy Medical Center Davenport Scott
Closed -
Intake
Only
Not
Available Mercy Medical Center Clinton Clinton
Closed -
Unreacha
ble
Not
Available Mercy Medical center
Closed -
Unreacha
ble
Not
Available Methodist Physians 57503 Thomas Council Bluffs
Pottawatta
mie
Closed -
Unreacha
ble
Not
Available Methodist Physicians Clinc Thomas Council Bluffs
Pottawatta
mie
Closed -
Unreacha
ble
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Not
Available Ob Gyn Associates PC 52406 Scott Monticello Jones
Closed -
Unreacha
ble
Not
Available OIHC FAMILY MEDICINE
Closed -
Enrolled
Not
Available Parks Area Clinic NS 2301 E 14th Mukati Des Moines Polk
Closed -
Enrolled
Not
Available Parks Family Practice Erin Des Moines Polk
Closed -
Unreacha
ble
Not
Available
PRIMARY HEALTH CARE
CLINIC
Closed -
Duplicate
Not
Available
Primary Healthcare at
Mercy Des Moines Polk
Closed -
Unreacha
ble
Not
Available Prior Authorization Clarinda Page
Closed -
Unreacha
ble
Not
Available Prior Authorization Unknown Des Moines Polk
Closed -
Intake
Only
Not
Available Prior Authorization Laurens
Pocahonta
s
Closed -
Unreacha
ble
Not
Available
SIOUX LAND COMMUNITY
HELATH CENTER TYLER Sioux City Woodbury
Closed -
Unreacha
ble
Not
Available
SIOUXLAND COMMUNITY
HEALTH
Closed -
Unreacha
ble
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Not
Available UHIC Ambulatory Care Andrea Davenport Scott
Closed -
Intake
Only
Not
Available UI Health Ventures 52761 Dr Muscatine Muscatine
Closed -
Unreacha
ble
Not
Available UIHV 52761 Michael Muscatine Muscatine
Closed -
Enrolled
Not
Available United Point Clinic 52761 Kim 52791
Closed -
Unreacha
ble
Not
Available Unity Point Cardiology 50309 Creston Union
Closed -
Enrolled
Not
Available Unity Point Cardiology Paton Greene
Closed -
Enrolled
Not
Available Unity Point Cardiology Sushma Indianola Warren
Closed -
Ineligible
Not
Available Unity Point Clinic Katie Norwalk Warren
Closed -
Already
Participati
ng
Not
Available Unity Point Clinic Jessica Marion Linn
Closed -
Declined
Not
Available Unity Point Clinic Peggy Muscatine Muscatine
Closed -
Enrolled
Not
Available Unity Point Clinic Des Moines Polk
Closed -
Enrolled
Not
Available Unity Point Clinic Simran Davenport Scott
Closed -
Intake
Only
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Not
Available
Unity Point Family
Medicine Beth Muscatine Muscatine
Closed -
Unreacha
ble
Not
Available
Unity Point Family
Medicine Amanda DAVENPORT Scott
Closed -
Enrolled
Not
Available
Unity Point Family
Medicine Lindsay Wyoming Jones
Closed -
Enrolled
Not
Available
Unity Point Family
Medicine Kevin Eldridge Scott
Closed -
Ineligible
o'brien Sanford Hartley Obrien
Closed -
Unreacha
ble
o'brien Sanford Hartley 51346 Angela Hartley Obrien
Closed -
Duplicate
Page
Charinda Regional Medical
Center Clarinda Page
Closed -
Unreacha
ble
Page Clarinda Medical Associates 220 Essie Davison Dr. Clarinda 51632 Steven Clarinda Page
Closed -
Enrolled
page
Clarinda Regional Health
Center 51632 Tish Clarinda Page
Closed -
Unreacha
ble
page CMA 51632 Autumn Clarinda Page
Closed -
Unreacha
ble
Page CRHC 51632 Amy Braddyville Page
Closed -
Enrolled
page Medical Clinic PC 51640 Kylie Sidney Fremont
Closed -
Enrolled
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
page Medical Clinic PC 51653 Kristin Tabor Fremont
Closed -
Unreacha
ble
Page Prior Authorization
One Jack Foster
Drive Shenandoah 51601 Todd Shenandoah Page
Closed -
Enrolled
page Prior Authorization 1 Jack Foster Drive Todd Shenandoah Page
Closed -
Enrolled
Page
Shenandoah Medical
Center Satya Shenandoah Page
Closed -
Unreacha
ble
PAGE
Shenandoah Physicians
Clinic 51601 Susan Shenandoah Page
Closed -
Unreacha
ble
Plymouth
Floyd Valley Healthcare
FMC 51031 Geri Lynn Le Mars Plymouth
Closed -
Declined
Pocahontas Prior Authorization
307 West Highway
10 Laurens 50554 Kylie Laurens
Pocahonta
s
Closed -
Unreacha
ble
Pocahontas Prior Authorization 608 NW 7th St Pocahontas 50574 Ted Pomeroy Calhoun
Closed -
Enrolled
Pochahonta
s Prior Authorization
307 West Highway
10 Kylie Laurens
Pocahonta
s
Closed -
Declined
Pochahonta
s Prior Authorization
307 West Highway
10 Laurens Kylie Laurens
Pocahonta
s
Closed -
Enrolled
Polk
BROADLAWNS FAMILY
PRACTICE
1801 HICKMAN
ROAD DES MOINES 50314 Des Moines Polk
Closed -
Unreacha
ble
Polk
Broadlawns Internal
Medicine Consult Clinic Jason Des Moines Polk
Closed -
Already
Participati
ng
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Polk DMU Clinic 3200 Grand Ave Des Moines 50312 April Des Moines Polk
Closed -
Enrolled
polk Mercy Beaverdale Clinic 50310 Mary Des Moines Polk
Closed -
Duplicate
polk Mercy Beaverdale Clinic Mary Des Moines Polk
Closed -
Unreacha
ble
Polk Mercy Capitol 4630 Douglas Des Moines 50309 Des Moines Polk
Closed -
Enrolled
Polk
Mercy West Family Practice
and Urgent Care 50325 Elizabeth Des Moines Polk
Closed -
Already
Participati
ng
Polk
Mercy West Family Practice
and Urgent Care 50325 Elizabeth Des Moines Polk
Closed -
Already
Participati
ng
Polk Oncol NS 1801 Hickman Rd Des Moines Julie Altoona Polk
Closed -
Unreacha
ble
polk Penn Ave Internal Medicine Lindsay Saint Marys Warren
Closed -
Unreacha
ble
polk Primary Health Care 50320 Rebecca Des Moines Polk
Closed -
Enrolled
Polk Primary Health Care Katy Ankeny Polk
Closed -
Intake
Only
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Polk
Primary Health Care @
Mercy 50314 Elizabeth Des Moines Polk
Closed -
Unreacha
ble
polk Primary Health Care Clinic 50320 Katy Ankeny Polk
Closed -
Duplicate
Polk Primary Health Care, Inc. 50314 Deanna Des Moines Polk
Closed -
Unreacha
ble
polk Primary Healthcare East 3509 E 29th St Louise Bondurant Polk
Closed -
Unreacha
ble
Polk Prior Authorization 5615 NW 86th St Johnston 50131 Jennifer Carlisle Warren
Closed -
Enrolled
Polk Prior Authorization 1350 Des Moines St Des Moines 50309 Sara
Closed -
Unreacha
ble
Polk Prior Authorization
2103 Ingersoll
Avenue Des Moines 50312 Robert Des Moines Polk
Closed -
Unreacha
ble
Polk Prior Authorization
6601 Southwest 9th
Street Des Moines 50315 Anne Altoona Polk
Closed -
Declined
Polk Prior Authorization 6601 SW 9th St Des Moines 50315 Anne Des Moines Polk
Closed -
Unreacha
ble
Polk Prior Authorization 4821 SW 9th St Des Moines 50315 Sheryl Des Moines Polk
Closed -
Intake
Only
Polk Prior Authorization 6601 SW 9th St Des Moins 50315 Lindy Des Moines Polk
Closed -
Declined
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Polk Prior Authorization 2301 E 14th St Des Moines 50316 Erin Des Moines Polk
Closed -
Intake
Only
Polk Prior Authorization 2901 86th St Urbandale 50322 Ed Urbandale Polk
Closed -
Enrolled
Polk Prior Authorization 2901 86th St Urbandale 50322 Ed
West Des
Moines Polk
Closed -
Enrolled
Polk Prior Authorization 5900 E University Pleasant Hill 50327 Tawnya Des Moines Polk
Closed -
Unreacha
ble
Polk Prior Authorization 5900 East University Pleasant Hill 50327 Illa Altoona Polk
Closed -
Enrolled
polk Prior Authorization
1211 Vine Street,
Suite 2224 Kathleen WDM Polk
Closed -
Enrolled
polk Southglen 50320 Unity Point Des Moines Polk
Closed -
Enrolled
polk Southglen Family Practice Amy Des Moines Polk
Closed -
Enrolled
Polk Southglen FP 7481 Hwy 65/69 Des Moines 50320 Jennifer Des Moines Polk
Closed -
Invalid
polk
UNITY POINT CLINCK PARKS
AREA 50316 Erin Des Moines Polk
Closed -
Declined
Polk
Unity Point East Des
Moines Family Medicine 50316 Alexandra Des Moines Polk
Closed -
Declined
polk UNITY POINT SOUTHGLEN Ankeny Polk
Closed -
Enrolled
polk UNITY POINT SOUTHGLEN
Closed -
Duplicate
polk Unity Point Southglen Jennifer Des Moines Polk
Closed -
Enrolled
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Pottawatta
mie All Care Health Center 51501 Kelly Sidney Fremont
Closed -
Unreacha
ble
pottawatta
mie All Care Health Center 51503 Christy Council Bluffs
Pottawatta
mie
Closed -
Declined
Pottawatta
mie All Care Health Center Teresa Council Bluffs
Pottawatta
mie
Closed -
Already
Participati
ng
Pottawatta
mie All Care Health Center Afeera Council Bluffs
Pottawatta
mie
Closed -
Intake
Only
Pottawatta
mie All Care Health Center Afeera Council Bluffs
Pottawatta
mie
Closed -
Declined
Pottawatta
mie CHI Health 51501 Joyce Council Bluffs
Pottawatta
mie
Closed -
Enrolled
Pottawatta
mie
Heartland Oncology and
Hematology 51503 Sakeer Neola
Pottawatta
mie
Closed -
Unreacha
ble
Pottawatta
mie
Methodist Council Bluffs
Ob/Gyn 51503 Lori Council Bluffs
Pottawatta
mie
Closed -
Enrolled
POTTAWATT
AMIE Methodist Edmunson 51503 Rachel Council Bluffs
Pottawatta
mie
Closed -
Unreacha
ble
POTTAWATT
AMIE
METHODIST JEANIE
EDMUNDSON HOSP 51503 Council Bluffs
Pottawatta
mie
Closed -
Enrolled
Pottawatta
mie METHODIST JENNIE PAUL Council Bluffs
Pottawatta
mie
Closed -
Unreacha
ble
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Pottawatta
mie
METHODIST JENNIE
EDMANDSON HOSP
Closed -
Already
Participati
ng
Pottawatta
mie
Methodist Jennie
Edmundson 51503 Dr Council Bluffs
Pottawatta
mie
Closed -
Unreacha
ble
POTTAWATT
AMIE
Methodist Jennie
Edmundson 51503 Evelyn Council Bluffs
Pottawatta
mie
Closed -
Unreacha
ble
POTTAWATT
AMIE
Methodist Jennie
Edmundson Hosp 51503 Council Bluffs
Pottawatta
mie
Closed -
Unreacha
ble
POTTAWATT
AMIE
Methodist Jennie
Edmundson Hosp
Missouri
Valley Harrison
Closed -
Unreacha
ble
POTTAWATT
AMIE
Methodist Jennie
Edmundson Hospital 51503 Council Bluffs
Pottawatta
mie
Closed -
Declined
POTTAWATT
AMIE
Methodist Jennie
Edmundson Hospital 51503 Red Oak
Montgome
ry
Closed -
Enrolled
pottawatta
mie Methodist Jennie Hosp Council Bluffs
Pottawatta
mie
Closed -
Unreacha
ble
Pottawatta
mie
METHODIST PHYSICAINS
CLINIC 51503 THOMAS Council Bluffs
Pottawatta
mie
Closed -
Unreacha
ble
Pottawatta
mie Methodist Physician Clinic 51503 Thomas Council Bluffs
Pottawatta
mie
Closed -
Enrolled
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Pottawatta
mie Methodist Physicians 51503 DR Nadia Carson
Pottawatta
mie
Closed -
Already
Participati
ng
Pottawatta
mie Methodist Physicians Clinic 51503 Thomas Carter Lake
Pottawatta
mie
Closed -
Unreacha
ble
Pottawatta
mie Methodist Physicians Clinic Thomas Council Bluffs
Pottawatta
mie
Closed -
Duplicate
Pottawatta
mie Prior Authorization
3135 W Broadway
Ste 100
Council
Bluffs 51501 Jamie Council Bluffs
Pottawatta
mie
Closed -
Enrolled
Pottawatta
mie Prior Authorization 1701 W Broadway Council Bluff 51501 Laura Council Bluffs
Pottawatta
mie
Closed -
Unreacha
ble
Pottawatta
mie Prior Authorization 1751 Madison Ave
Council
Bluffs 51503 Elizabeth Carter Lake
Pottawatta
mie
Closed -
Declined
pottawatta
mie Prior Authorization 3135 W Broadway Council Bluff Kavish Council Bluffs
Pottawatta
mie
Closed -
Unreacha
ble
Rinnggold Mount Ayr Medical Clinic 50854 Ron Kellerton Ringgold
Closed -
Duplicate
Rinnggold Mount Ayr Medical Clinic 50854 Ron Kellerton Ringgold
Closed -
Duplicate
Rinnggold Mount Ayr Medical Clinic 50854 Ron Kellerton Ringgold
Closed -
Enrolled
Sac McCray Rost Clinic 1160 3rd St Lakeview 51450 Mark Auburn Sac
Closed -
Unreacha
ble
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Sac Prior Authorization 301 Hynland Ave Sac City 50583 Bernadette Newell
Buena
Vista
Closed -
Unreacha
ble
Scott Cardiovascular Medicine 52803 Peter Davenport Scott
Closed -
Intake
Only
Scott Community Health Care 52801 Anne Davenport Scott
Closed -
Unreacha
ble
Scott Community Health Care 52801 Anne Davenport Scott
Closed -
Unreacha
ble
Scott Community Health Care 52801 Sarah Davenport Scott
Closed -
Intake
Only
Scott Community Health Care 52801 Stephanie Davenport Scott
Closed -
Unreacha
ble
Scott Community Health Care 52801 Stephanie Davenport Scott
Closed -
Intake
Only
Scott Community Health Care 52804 Davenport Scott
Closed -
Enrolled
Scott Community Health Care Ashlee Davenport Scott
Closed -
Invalid
Scott Community Health Care Davenport Scott
Closed -
Unreacha
ble
Scott Community Health Care Stephanie Davenport Scott
Closed -
Unreacha
ble
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Scott COMMUNITY HEALTH CARE
Closed -
Unreacha
ble
Scott COMMUNITY HEALTH CARE
Closed -
Enrolled
Scott Community Health Care Anne Davenport Scott
Closed -
Declined
Scott
COMMUNITY HEALTH
CENTER
Closed -
Invalid
Scott
COMMUNITY HEALTH
CENTER
Closed -
Unreacha
ble
Scott
COMMUNITY HEALTH
CENTER
Closed -
Invalid
Scott
Genesis Family Medical
Center 1345 W Central Park Davenport 52804 Davenport Scott
Closed -
Unreacha
ble
Scott Genesis Health Group 52722 Jason Bettendorf Scott
Closed -
Already
Participati
ng
Scott Genesis Health Group 301 N 4th St Eldridge 52748 Carla Eldridge Scott
Closed -
Ineligible
Scott Genesis Health Group Jason Bettendorf Scott
Closed -
Enrolled
Scott
Genesis Pulmonary
Associates 52807 Humphrey Davenport Scott
Closed -
Unreacha
ble
Scott Gensis Family Center 1345 W Central Pk Davenport 52804 DAVENPORT Scott
Closed -
Declined
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Scott Medicaid Referral 1345 W Central pk Davenport Dr Davenport Scott
Closed -
Enrolled
Scott Prior Authorization 2140 53rd Avenue Bettendorf 52722 Stacie Davenport Scott
Closed -
Unreacha
ble
Scott Prior Authorization
301 North 4th
Avenue Eldridge 52748 Carlos ELDRIDGE Scott
Closed -
Enrolled
Scott Prior Authorization 1345 W Central Pk Davenport 52804 Christina Eldridge Scott
Closed -
Enrolled
Scott Prior Authorization 4317 53rd Street Janki
Closed -
Enrolled
Scott Prior Authorization 1345 W Central Park Davenport Thang Davenport Scott
Closed -
Unreacha
ble
Scott Prior Authorization 1345 W Central Pk Davenport Jen ELDRIDGE Scott
Closed -
Enrolled
Scott Unity Point Clinic B
4480 Utica Ridge Rd
Suite 2236 Betterndorf 52722 Nilsn Davenport Scott
Closed -
Declined
Scott Unity Point Clinic B 4480 Utica Ridge Rd Bettendorf Nilesh Davenport Scott
Closed -
Enrolled
Scott Unity Point Spring St Davenport Scott
Closed -
Intake
Only
shelby
Myrtue Center Department
of Community Health 51537
HCCMS
Family
Health
Services Harlan Shelby
Closed -
Already
Participati
ng
sioux
Hawarden Regional
Healthcare 51023 Mindy HAWARDEN Sioux
Closed -
Unreacha
ble
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
sioux
Hawarden Regional
Healthcare 51023 Beau Hawarden Sioux
Closed -
Enrolled
south
dakota Avera Medical Group 51334 Anthony Estherville Emmet
Closed -
Duplicate
south
dakota
Avera Medical Group
Pulmonary 57105 Dr Estherville Emmet
Closed -
Enrolled
south
dakota Avera Pulmonary Ashton Osceola
Closed -
Unreacha
ble
south
dakota
AVERA PULMONARY AND
SLEEP 57105 DR Terril Dickinson
Closed -
Already
Participati
ng
Story McFarland Clinic PC 1215 Duff Ave Ames 50010 Ricardo Ames Story
Closed -
Unreacha
ble
Tama Prior Authorization 501 Clark Street Dysart 52224 Nicole Waterloo Black Hawk
Closed -
Invalid
Taylor CHI 50833 Allison New Market Taylor
Closed -
Already
Participati
ng
Taylor Hardin Clinic 408 Dodge St Bedford 50833 Michelle Coin Page
Closed -
Intake
Only
Taylor Hardin Clinic 408 Dodge St Bedford 50833 Michelle Coin Page
Closed -
Intake
Only
Taylor Lenox Medical Clinic 100 S Main St Lenox 50851 Darcy Lenox
Closed -
Enrolled
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Union GRMC 1700 W Townline St Creston 50801 Lonny Wilton Muscatine
Closed -
Invalid
van buren Fox RIver Clinic Birmingham Van Buren
Closed -
Declined
VanBuren Prior Authorization 307 Franklin Street Keosauqua 52565 James Bloomfield Davis
Closed -
Enrolled
Wapello Eddieville Clinic
PO Box 576 107 N
3rd Eddieville 52553 Shelley Eddyville Wapello
Closed -
Enrolled
Wapello
River Hills Community
Health Center Kim Ottumwa Wapello
Closed -
Ineligible
Warren Prior Authorization
307 East Scenic
Valley Avenue Indianola 50125 Sarah Milo Warren
Closed -
Unreacha
ble
Washington Prior Authorization
3056 Rivercrossing
Ct Riverside 52327 David Keokuk Lee
Closed -
Unreacha
ble
Washington Prior Authorization
3056 River Crossing
Court Riverside 52327 Elizabeth Washington
Washingto
n
Closed -
Unreacha
ble
Washington WCHC Family Medicine 1230 S Iowa Ave Washington 52353 Matthew Washington
Closed -
Enrolled
Webster Community Health Center
126 North 10th
Street Fort Dodge 50501 Darlene Badger Webster
Closed -
Unreacha
ble
Webster Community Heath Center
126 North 10th
Street Fort Dodge 50501 Ann Fort Dodge Webster
Closed -
Unreacha
ble
Webster Prior Authorization 176 N 10th St Fort Dodge 50501 Michelle Fort Dodge Webster
Closed -
Unreacha
ble
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Webster Prior Authorization 126 N10th St Ft Dodge 50501 Michelle Fort Dodge Webster
Closed -
Enrolled
Webster Prior Authorization 800 Kenyon Rd Fort Dodge 50501 Jennifer Fort Dodge Webster
Closed -
Enrolled
Webster Prior Authorization
126 North 10th
Street Jennifer
Closed -
Unreacha
ble
Winneshiek winneshiek medical center 52101 kristen Decorah
Winneshie
k
Closed -
Unreacha
ble
Woodbury Family Medicine Center 51104 Dr Sioux City Woodbury
Closed -
Unreacha
ble
Woodbury Family Medicine Clinic 51104 Dr Dakota City Dakota
Closed -
Invalid
woodbury Jackson Recovery 800 5th st Sioux City Rachel Sioux City Woodbury
Closed -
Enrolled
woodbury
Mercy Medical Center Sioux
City 51102 Sioux City Woodbury
Closed -
Unreacha
ble
Woodbury Prior Authorization 307 East Main Street Anthon 51004 James Correctionville Woodbury
Closed -
Unreacha
ble
Woodbury Prior Authorization
1021 Nebraska
Street Sioux City 51105 Lavone
Closed -
Declined
Woodbury
Sioux Land Community
Health 51105 Sioux City Woodbury
Closed -
Unreacha
ble
Woodbury
SIOUX LAND COMMUNITY
HEALTH CENTER 51105
Closed -
Enrolled
County Clinic Name Clinic Address Clinic City
Clinic Zip
Code
Referred
By First
Name
Participant
City
Participant
County Status
Woodbury
Sioux Land Community
Health Center 51105 Staci Sioux City Woodbury
Closed -
Unreacha
ble
Woodbury
Siouxland Community
Health Center 51105 Staci Sioux City Woodbury
Closed -
Enrolled
Woodbury
Siouxland Community
Health Center 51105 Staci Sioux City Woodbury
Closed -
Intake
Only
Woodbury
Siouxland Medical
Education Foundation 2501 Pierce St Sioux City 51104 Cara
Closed -
Ineligible
Woodbury
Siouxland Medical
Education Foundation 2501 Pierce St Sioux City 51104 Cara
Closed -
Duplicate