Provider Demographics
NPI:1760800551
Name:JASPER COUNTY HEALTH VENTURES LLC
Entity Type:Organization
Organization Name:JASPER COUNTY HEALTH VENTURES LLC
Other - Org Name:NEWTON EXPRESS CARE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:THAYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-792-2112
Mailing Address - Street 1:300 N 4TH AVE E STE 200
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:IA
Mailing Address - Zip Code:50208-3122
Mailing Address - Country:US
Mailing Address - Phone:641-792-2112
Mailing Address - Fax:
Practice Address - Street 1:1501 1ST AVE E
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:IA
Practice Address - Zip Code:50208-4045
Practice Address - Country:US
Practice Address - Phone:641-792-2112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-31
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty