SIOUX VALLEY LAKE PARK CLINIC
NPI 1619050929
Nurse Practitioner in Lake Park, IA

Q: What is Sioux Valley Regional Health Services's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Active since October 23, 2006

204 MARKET ST., LAKE PARK, IA 51347(712) 832-9559(712) 832-3801 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Sioux Valley Lake Park Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SIOUX VALLEY LAKE PARK CLINIC (NPI 1619050929) is a healthcare organization registered as a nurse practitioner in Lake Park, Iowa and active in the NPI registry since October 2006. The organization lists Joel Mason Gustafson, Administrator, as its authorized official.

NPPES Registry Identity

NPI1619050929

Entity TypeOrganization

Primary Taxonomy363L00000X

Legal Business NameSIOUX VALLEY REGIONAL HEALTH SERVICES

Location Address204 MARKET ST.Lake Park, IA 51347

Mailing Address204 Market St., P.o. Box 627Lake Park, IA 51347 · (712) 832-9559 · Fax (712) 832-3801

Phone(712) 832-9559

Fax(712) 832-3801

Organization SubpartNo

Authorized OfficialJoel Mason GustafsonAdministrator · (712) 324-5356

Enumeration DateOctober 23, 2006

Last NPPES UpdateAugust 22, 2020

✔ NPI 1619050929 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

204 MARKET ST., Lake Park, IA 51347

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Other Names 1

Doing Business AsSioux Valley Lake Park Clinic

Other Identifiers 1

Medicaid0689091IA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sioux Valley Regional Health Services's NPI number?

The NPI number for Sioux Valley Regional Health Services is 1619050929. It was assigned to this organization in the NPPES registry on October 23, 2006. The provider is doing business as Sioux Valley Lake Park Clinic.

Where is Sioux Valley Regional Health Services located?

Sioux Valley Regional Health Services is located at 204 Market St., Lake Park, IA 51347. The listed phone number is (712) 832-9559.

What is Sioux Valley Regional Health Services's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Sioux Valley Regional Health Services was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.