County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Adams CHI 50841 Hagen Traci Corning Adams Closed -

Already

Participating

Allamakee Gundersen Health

System

52172 Everman Jessica Lansing Allamakee Closed -

Enrolled

Allamakee Gundersen Health

System

52172 Barbee Dr. Waukon Allamakee Closed -

Duplicate

Audubon Audobon Family

Health Care

50025 Stubbs Christop

her

Audubon Audubon Closed -

Unreachable

Benton Unity Point Clinic 52208 Fults Angela Belle Plaine Benton Closed -

Duplicate

Black Hawk FAM MED

WATERLOO

Waterloo Black Hawk Closed -

Enrolled

Blackhawk Covenant-

Pulmonology

50702 Mehta Pankaj Waterloo Black Hawk Closed -

Unreachable

Blackhawk Peoples Clinic 50703 Gatz Emily Waterloo Black Hawk Closed -

Enrolled

Blackhawk Peoples Community

Health Clinic

50703 Gutz Emily Waterloo Black Hawk Closed -

Already

Participating

Blackhawk Family Medicine

Waterlo UnityPoint

Clinic

50703 Hall Martha Waterloo Black Hawk Closed -

Already

Participating

Blackhawk Family Medicine

Waterloo

50703 Brown Teresa Denver Bremer Closed -

Unreachable

Blackhawk Family Medicine

Wsterlo UnityPoint

Clinic

50703 Hall Martha Waterloo Black Hawk Closed -

Unreachable

Blackhawk PEOPLES

COMMUNITY

HEALTH CLINIC

50703 Kane Sarah Independenc

e

Buchanan Closed -

Enrolled

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Boone Prior Authorization 1115

South

Marshall

Street

Boone 50036 Anderson Joshua Madrid Boone Closed -

Unreachable

Boone Boone Family

Medicine North Clinic

50036 Mehlhaus Dr BOONE Boone Closed -

Declined

Bremer Waverly Health Clinic Women's

Clinic

50677 Rathe Ann Forest City Winnebago Closed -

Unreachable

Butler Prior Authorization 502

Locust

Allison 50602 Foxen Montica Parkersburg Butler Closed -

Unreachable

Butler Peoples Clinic Butler

County

50619 Hoelscher Courtne

y

Charles City Floyd Closed -

Already

Participating

Butler Unity Point / Allison

Family Practice

50602 Foxen Montica Parkersburg Butler Closed -

Unreachable

Calhoun McCrary Rost Clinic 51449 HORNBACK DR

SUSAN

Pomeroy Calhoun Closed -

Unreachable

Calhoun Calhoun County

Public Health

50579 Rockwell

City

Calhoun Closed -

Already

Participating

Cass Prior Authorization 1501

East 10th

Street

Atlantic 50022 Weppler Angela Griswold Cass Closed -

Unreachable

Cass Anita Medical Center 50020 Bean Stacey Atlantic Cass Closed -

Unreachable

Cass Atlantic Medical

Center

50022 Robinson Mary Walnut Pottawattami

e

Closed -

Unreachable

Cerro Gordo Prior Authorization 1010 4th

St SW

Ste 340

Mason

City

50401 Parekh Mason City Cerro Gordo Closed -

Enrolled

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Cerro Gordo Prior Authorization 1010 4th

Street

SW,

Suite 340

Mason

City

50401 Singh Jasjit Mason City Cerro Gordo Closed -

Unreachable

Cerro Gordo Mercy North Iowa -

Internal Medicine

50401 Dunlay Patrick Mason City Cerro Gordo Closed -

Already

Participating

Cerro Gordo Mercy Internal

Medicine Clinic

50401 Gannon Kathlee

n

Mason City Cerro Gordo Closed -

Unreachable

Cerro Gordo Mercy Family

Medicine Residency

50401 Kersbergen David Closed -

Intake Only

Cerro Gordo Regency Clinic Mercy 50401 Wagner Cheriely

nn

Major City Closed -

Unreachable

Cerro Gordo Mercy Family

Residency

50401 Jewell Brianna Garner Hancock Closed -

Duplicate

Cherokee Cherokee Region

Clinic

300 sioux

Valley Dr

Cheroke

e

51012 Mogensen-

Kruger

Rebecc

a

Cherokee Closed -

Unreachable

Cherokee Cherokee Family

Practice

51012 Woodall Jan Cherokee Cherokee Closed -

Unreachable

Clay Megan Van Otterloo 116 E

11th St

Spencer 51301 Van Otterloo Megan Spencer Clay Closed -

Unreachable

Clinton Prior Authorization 102111th

St

De Witt 52742 Laureys Peter De Witt Clinton Closed -

Enrolled

Clinton Community Health

Care

925 S 4th

St

Clinton 52732 Clinton Clinton Closed -

Unreachable

Clinton Prior Authorization 915 13th

Ave N

Clinton 52732 Ansari Clinton Clinton Closed -

Enrolled

Clinton Medical Associates 52732 Kauffman T Clinton Clinton Closed -

Unreachable

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Clinton Community Health

Care

52732 Fuller Ashley Clinton Clinton Closed -

Enrolled

Clinton Mercy Medical

Center Clinton

52732 Clinton Clinton Closed -

Unreachable

Clinton Mercy Medical

Center Clinton

52732 Bryant Clinton Closed -

Unreachable

Dakota, Ne Siouxland

Community Health

Center of Nebraska

68776 Faldmo David Sioux City Woodbury Closed -

Already

Participating

Dallas Prior Authorization 1120

Greene

St

Adel 50003 Waukee Dallas Closed -

Enrolled

Dallas Mercy Clinic Perry 50220 Sohn Steven Perry Dallas Closed -

Unreachable

Dallas Dallas Center

Medical Associates

50063 Eernisse Dr De Soto Dallas Closed -

Intake Only

Decatur Iowa Heart Center 50264 Wickemeyer William Centerville Appanoose Closed -

Ineligible

Delaware Regional Family

Health

52050 Book C Earlville Delaware Closed -

Enrolled

Des Moines Community Health

Center Southeast

Iowa

52655 Havenstein Naarah Burlington Des Moines Closed -

Unreachable

Des Moines CHC 52655 Kisunni V Burlington Des Moines Closed -

Alternate

Client

Douglas Not provided 4220 L St Omaha 68107 Hare Mark Council

Bluffs

Pottawattami

e

Closed -

Enrolled

Douglas, Ne Nebraska Medicine 68198 Darrah Lauren Council

Bluffs

Pottawattami

e

Closed -

Already

Participating

Dubuque Prior Authorization 1515

Delhi St

Dubuqu

e

52001 Fanuyide Victoria Dubuque Dubuque Closed -

Intake Only

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Fayette Covenant Clinic 50662 Dalie Nasredi

n

Maynard Fayette Closed -

Enrolled

Grundy CS LaTendresse

Medical Clinic

50638 LaTendresse Charles Grundy

Center

Grundy Closed -

Unreachable

Hamilton Van Diest Family

Medical Clinic

2350

Hospital

Dr

Webster 50595 Sahari Subhas

h

Webster City Hamilton Closed -

Enrolled

Hardin Prior Authorization 103 E

Ellsworth

Dows 50126 Landers Daphne Dows Wright Closed -

Enrolled

Hardin McFarland Clinic Iowa

Falls

50126 Heiar Aaron Iowa Falls Hardin Closed -

Enrolled

Hardin Prior Authorization 1506

Edgingto

n Avenue

Eldora 50627 Kenkel Carrie Eldora Hardin Closed -

Intake Only

Howard Prior Authorization 321 8th

Avenue

West

Cresco 52136 Haas Mary Cresco Howard Closed -

Enrolled

Howard Cresco Medical Clinic 52136 Kammerer Jon Cresco Howard Closed -

Unreachable

Jackson Prior Authorization 918 West

Platt

Street,

Suite 1

Maquok

eta

52060 Peterson Eric Maquoketa Jackson Closed -

Enrolled

Jackson Medical Associates 52060 THOMPSON DR K Baldwin Jackson Closed -

Enrolled

Jackson Mercy Care Second

Ave

52403 Schultes Robert Marion Linn Closed -

Unreachable

Jackson MercyCare Second

Avenue

52403 Schultes Robert Marion Linn Closed -

Current

Appointment

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Jasper Prior Authorization 100 East

Jefferson

Prairie

City

50228 Ingle Greg Des Moines Polk Closed -

Unreachable

Jasper Not Given 50208 Bantell Stephan

ie

Newton Jasper Closed -

Current

Appointment

Jasper Unknown 50209 Bartell Stephan

ie

Newton Jasper Closed -

Unreachable

Jasper Monroe Family

Health Center

50170 Dejong Diane Monroe Jasper Closed -

Unreachable

Jasper Newton Clinic 50208 B Stephan

ie

Kellogg Jasper Closed -

Declined

Johnson Prior Authorization 105 East

9th

Street

Coralvill

e

52241 Goerdt Christop

her

Iowa City Johnson Closed -

Unreachable

Johnson Prior Authorization 3 Lions

Drive, PO

Box 927

North

Liberty

52317 Hong Arthur North Liberty Johnson Closed -

Unreachable

Johnson UIHC Family Med 200

Hawkins

Dr

Iowa

City

52242 Veit Leslie Iowa City Johnson Closed -

Enrolled

Johnson UIHC Family

Medicine

200

Hawkins

Drive

Iowa

City

52242 Wilcox Garrett Iowa City Johnson Closed -

Enrolled

Johnson Prior Authorization 3 Lions

Drive

North

Liberty

52317 Saunders Katharin

e

Closed -

Invalid

Johnson Prior Authorization 801

Newton

Road

Iowa

City

52246 Antoniare Marian Closed -

Unreachable

Johnson Prior Authorization 105 East

9th

Street

Coralvill

e

52241 Katz David Coralville Johnson Closed -

Enrolled

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Johnson Prior Authorization 200

Hawkins

Drive

Iowa

City

52242 Coleman Lastasci

a

Iowa City Johnson Closed -

Enrolled

Johnson Prior Authorization UIHC

Ophthal

mology -

200

Hawkins

Drive

Iowa

City

52242 Shriver Erin Washington Washington Closed -

Enrolled

Johnson Prior Authorization 269

North 1st

Avenue

Iowa

City

52245 Loeb Elizabet

h

North Liberty Johnson Closed -

Enrolled

Johnson Family Medicine

Clinic

Iowa

City

52242 Shian Brian Iowa City Johnson Closed -

Unreachable

Johnson University of Iowa

Hospitals and Clinics

Flanders Katherin

e

Iowa City Johnson Closed -

Unreachable

Johnson Iowa River Landing

East Family Med

52241 Banu Dr Columbus

Junction

Louisa Closed -

Intake Only

Johnson University of Iowa

Hospitals & Clinics

52242 Flanders Kathryn Iowa City Johnson Closed -

Enrolled

Johnson UIHC Virology 52242 Kaur Amrit CEDAR

RAPIDS

Linn Closed -

Unreachable

Johnson University of Iowa

College of Dentistry

52246 Swenson DR

Robert

Fort

Madison

Lee Closed -

Enrolled

Johnson P Rehab and

University of Iowa

Hospital and Clinic

52240 Berimer Jane Iowa City Johnson Closed -

Intake Only

Johnson University of Iowa

Hospital Clinic

52242 Siquardsson Gardar Chariton Lucas Closed -

Enrolled

Johnson IRL East Family

Medicine

52241 Banu Hussain Iowa City Johnson Closed -

Intake Only

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Jones Jones Regional

Medical Family

Practice

52205 Schepanski Alissa Central City Linn Closed -

Enrolled

Jones Unity Point Cascade

Family Medicine

52033 Rohr Debra Bernard Dubuque Closed -

Enrolled

Lee Prior Authorization 400

North

17th

Street

Keokuk 52632 Barrows Lindsey Fort

Madison

Lee Closed -

Unreachable

Lee IA Dept of Human

Services

1411

Main St

Keokuk 52632 Octken Annette Keokuk Lee Closed -

Enrolled

Lee CHC.SEIA 52632 Barrows Lindsey Fort

Madison

Lee Closed -

Current

Appointment

Lee Community Health

Center of SE IA

52632 Cloke Tia Mount

Pleasant

Henry Closed -

Unreachable

Lee The Keokuk Clinic 52632 Qasim Tank Keokuk Lee Closed -

Unreachable

Linn Prior Authorization 600 7th

st se ste

101

Cedar

Rapids

52401 Meeker Monica Cedar

Rapids

Linn Closed -

Enrolled

Linn Prior Authorization 2375

Edgewoo

d Road

SW

Cedar

Rapids

52404 Kahler Melissa Cedar

Rapids

Linn Closed -

Unreachable

Linn Prior Authorization 500 8th

Avenue

SE

Cedar

Rapids

52401 Hopper Katherin

e

Cedar

Rapids

Linn Closed -

Unreachable

Linn Eastern Iowa Health

Center

1201 3rd

Avenue

SE

Cedar

Rapids

52404 Siddagunta Chiranje

evi

Central City Linn Closed -

Unreachable

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Linn Eastern Iowa Health

Center

1201 3rd

Avenue

SE

Cedar

Rapids

52403 Wilson Amy Coggon Linn Closed -

Duplicate

Linn Eastern Iowa Health

Center

1201 3rd

Ave SE

Cedar

Rapids

52403 Wilson Amy Cedar

Rapids

Linn Closed -

Declined

Linn Unity Point Bowman

Woods

6911 C

Ave NE

Cedar

Rapids

52402 Minjeur Monica Marion Linn Closed -

Unreachable

Linn Prior Authorization 9255

Atlantic

Dr

Cedar

Rapids

52404 Alatorre Katherin

e

Cedar

Rapids

Linn Closed -

Unreachable

Linn Eastern Iowa Health

Center

1201 3rd

Avenue

SE

Cedar

Rapids

52403 Wilson Amy Closed -

Current

Appointment

Linn Prior Authorization 3933 Mt

Vernon

Rd SE

Cedar

Rapids

52403 Soenen Ann Cedar

Rapids

Linn Closed -

Unreachable

Linn Dr Anshul Jain 2375

Edgewoo

d Road

SW

Cedar

Rapids

Jain Anshul Cedar

Rapids

Linn Closed -

Unreachable

Linn Unity Bowman-Hoods

Family Medicine

52402 Stewart Terasa Cedar

Rapids

Linn Closed -

Unreachable

Linn Unity Point

Northridge

52233 Throndson Shanno

n

Cedar

Rapids

Linn Closed -

Unreachable

Linn Eastern Iowa Health

Center

52403 Schabilion Rose Cedar

Rapids

Linn Closed -

Enrolled

Linn Eastern Iowa Health

Center

52404 Bryne David Marion Linn Closed -

Enrolled

Linn Unity Point Bowman

Woods Family

Medicine

52402 Stewart Terasa Cedar

Rapids

Linn Closed -

Enrolled

Linn Eastern Iowa Health

Center

52403 Bayramgalin Rafael Cedar

Rapids

Linn Closed -

Unreachable

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Linn Unity Point Multi

Specialty

52402 Henry Mary Jo Cedar

Rapids

Linn Closed -

Unreachable

Linn Eastern Iowa Health

Center

52403 Efimov Alexand

re

Cedar

Rapids

Linn Closed -

Intake Only

Linn Eastern Iowa Health

Center

52403 Efimov Alexand

re

Cedar

Rapids

Linn Closed -

Duplicate

Linn Eastern Iowa Health

Center

52402 Hood Zachary Cedar

Rapids

Linn Closed -

Already

Participating

Linn Eastern Iowa Health

Center

52404 Siddagunta Chiranje

evi

Cedar

Rapids

Linn Closed -

Ineligible

Linn Eastern Iowa Health

Center

52403 Zadounaev Ivan Cedar

Rapids

Linn Closed -

Intake Only

Linn Unity Point Bowman

Woods

52402 Minjeur Monica Marion Linn Closed -

Unreachable

Linn Unity Point Bowman

Woods Family Med

52402 Stewart Teresa Cedar

Rapids

Linn Closed -

Enrolled

Linn Unity Point Clinic

Bowman Woods

52402 LeClere Brandy Cedar

Rapids

Linn Closed -

Unreachable

Louisa Community Health

Centers of

Southeaster IA

52737 Winfield Henry Closed -

Intake Only

Lucas Lucas County Health

Center Medical Clinic

Krutsinger Allison Chariton Lucas Closed -

Already

Participating

Lucas Lucas County Health

Center Medical Clinic

50049 Krutsinger Allison Chariton Lucas Closed -

Enrolled

Lucas Sanford Clinic Rock

Rapids

51246 Hamon Beta Doon Lyon Closed -

Duplicate

Lyon Sanford Clinic Rock

Rapids

51246 Hamon Beta Doon Lyon Closed -

Unreachable

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Lyon Stanford Clinic Rock

Rapids

51246 Roemen Rebecc

a

Inwood Lyon Closed -

Invalid

Lyon Sanford Rock Rapids

Clinic

51246 Van Hill Kathy Little Rock Lyon Closed -

Unreachable

Mahaska Stefanie Yearian 1229 C

Ave E

Oskaloo

sa

52577 Yearian Stefanie OSKALOOS

A

Mahaska Closed -

Unreachable

Mahaska mhp 1229 c

ave e

Oskaloo

sa

52577 Fowler Jeffrey Oskaloosa Closed -

Declined

Mahaska MHP 1229 C

AVE E

Oskaloo

sa

52577 SCOTT JEN Barnes City Closed -

Intake Only

Marion Pella Regional Health

Center

Amble Jamie Monroe Jasper Closed -

Unreachable

Marion Knoxville Hospital

and Clinic

Remington Shanno

n

Melcher

Dallas

Marion Closed -

Unreachable

Marion Knoxville Hospital

and Clinic

Remington Shanno

n

Melcher

Dallas

Marion Closed -

Declined

Marion Pella Regional Health

Center

50219 Amble Jamie Pella Marion Closed -

Enrolled

Marshall McFarland Clinic 312 E

Main St

Marshallt

own

50158 Berry Nicole Marshalltow

n

Marshall Closed -

Unreachable

Marshall Marshalltown Ob Gyn

Clinic

50158 Schmoker Autumn Marshalltow

n

Marshall Closed -

Enrolled

Marshall Substance Abuse

Treatment Unit of

Central Iowa

50158 Marshalltow

n

Marshall Closed -

Already

Participating

Marshall McFarland Clinic 50158 Megan Marshalltow

n

Marshall Closed -

Duplicate

Mills Methodist Physicians

clinic

415 Main

St

Malvern 51551 Wilson ARNP Krista Malvern Closed -

Unreachable

Monona Prior Authorization 1614

Diamond

Street

Onawa 51040 Kahl Tracy Onawa Monona Closed -

Unreachable

Monona Burgess Medical

Center

Kovar Dr Whiting Monona Closed -

Duplicate

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Monona Burgess Medical

Center

Kovar Dr Whiting Monona Closed -

Duplicate

Monona Burgess Medical

Center

51040 Kovar Whiting Monona Closed -

Unreachable

Muscatine UICMS Muscatine 52761 Tislinger Christin

e

Muscatine Muscatine Closed -

Ineligible

Muscatine UI CMS-

MUSCATINE

52761 Tisinger Christin

e

Letts Louisa Closed -

Unreachable

Not

Available

SANFORD ROCK

RAPIDS

HAMON BETA Rock Rapids Lyon Closed -

Already

Participating

Not

Available

METHODIST

PHYSICIANS CLINIC

Closed -

Already

Participating

Not

Available

People Choice

Community Health

Clinic

Henderson Vicki Waterloo Black Hawk Closed -

Enrolled

Not

Available

Prior Authorization Closed -

Enrolled

Not

Available

Prior Authorization Bettendorf Scott Closed -

Enrolled

Not

Available

CMA Schaffer Bryon Clarinda Page Closed -

Unreachable

Not

Available

Unity Point Clinic Imhoff Debbie Muscatine Muscatine Closed -

Unreachable

Not

Available

Prior Authorization Cedar

Rapids

Linn Closed -

Unreachable

Not

Available

Not Legible Ottumwa Wapello Closed -

Duplicate

Not

Available

Community Health

Care

Chana Davenport Scott Closed -

Enrolled

Not

Available

CHC/SEIA Kiswano Vandha

na

Burlington Des Moines Closed -

Already

Participating

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Not

Available

PRIMARY HEALTH

CARE

Closed -

Already

Participating

Not

Available

METHODIST

PHYSICIANS CLIIC

Closed -

Unreachable

Not

Available

Prior Authorization Fort Dodge Webster Closed -

Unreachable

Not

Available

Villisca Family Health

Center

Villisca Montgomery Closed -

Unreachable

Not

Available

Community Health

Care

Misiag Ashlee Davenport Scott Closed -

Already

Participating

Not

Available

Prior Authorization Le Claire Scott Closed -

Unreachable

Not

Available

CCMIT MED CLINIC Vail Crawford Closed -

Already

Participating

Not

Available

LaTendressa Medical

Clinic

Grundy

Center

Grundy Closed -

Unreachable

Not

Available

Prior Authorization Flonders Kathyrn Iowa City Johnson Closed -

Unreachable

Not

Available

Prior Authorization Ottumwa Wapello Closed -

Unreachable

Not

Available

Prior Authorization 107

North 3rd

Street

Eddyville Bechtel Shelley Ottumwa Wapello Closed -

Unreachable

Not

Available

Prior Authorization Independenc

e

Buchanan Closed -

Unreachable

Not

Available

MERCY FAM CLINIC

LAKE MILLS

Lake Mills Winnebago Closed -

Unreachable

Not

Available

Prior Authorization Lake City Calhoun Closed -

Unreachable

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Not

Available

Prior Authorization Schloss Sarah Cedar

Rapids

Linn Closed -

Enrolled

Not

Available

Prior Authorization Des Moines Polk Closed -

Unreachable

Not

Available

Nashua Clinic Hensley Tara Nashua Chickasaw Closed -

Unreachable

Not

Available

Siouxland

Community Center

of Nebraska

Fahmo David Closed -

Unreachable

Not

Available

VAN BUREN

COUNTY HOSPITAL

AND CLINIC

Keosauqua Van Buren Closed -

Unreachable

Not

Available

University of IA Hsp Washington Washington Closed -

Declined

Not

Available

Prior Authorization Fort

Madison

Lee Closed -

Unreachable

Not

Available

Community Health

Center

Hauentein Naarah West Point Lee Closed -

Unreachable

Not

Available

PRIMOARY HEALTH

CARE

Marshalltow

n

Marshall Closed -

Unreachable

Not

Available

MCFARLAND

CLINIC PC

Marshalltow

n

Marshall Closed -

Unreachable

Not

Available

St. Amsgar Clinic Osage Mitchell Closed -

Unreachable

Not

Available

Prior Authorization Council

Bluffs

Pottawattami

e

Closed -

Unreachable

Not

Available

Prior Authorization Thurman John Burlington Des Moines Closed -

Unreachable

Not

Available

Family Medicine of

Mt Pleasant

Gratz Katie Wayland Henry Closed -

Unreachable

Not

Available

Prior Authorization Brownell John Cedar

Rapids

Linn Closed -

Unreachable

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Not

Available

Prior Authorization Des Moines Polk Closed -

Unreachable

Not

Available

Prior Authorization Des Moines Polk Closed -

Unreachable

Not

Available

Prior Authorization Boone Boone Closed -

Unreachable

Not

Available

CHC ISEIA Burlington Des Moines Closed -

Enrolled

Not

Available

ATLANTIC MED CTR Atlantic Cass Closed -

Declined

Not

Available

UNIVERSITY OF IA

SOUTHEAST IA

Moscow Muscatine Closed -

Unreachable

Not

Available

Shununddoah

Medical Center

Shenandoah Page Closed -

Declined

Not

Available

Prior Authorization Conrad Grundy Closed -

Intake Only

Not

Available

Prior Authorization Eldridge Scott Closed -

Unreachable

Not

Available

unknown 321 MILL

ST

akron wolft david gowrie Plymouth Closed -

Unreachable

Not

Available

UILLISCA FAM

HEALTH

Villisca Montgomery Closed -

Unreachable

Not

Available

MEDICAL

ASSOCIATES

KAUFFMAN THERS

A

Clinton Clinton Closed -

Unreachable

Not

Available

Prior Authorization Wintermote Heidi Prairie City Jasper Closed -

Already

Participating

Not

Available

McCrary Kost Pomeroy Calhoun Closed -

Unreachable

Not

Available

MC CRARY ROST

CLINIC

Closed -

Duplicate

Not

Available

BROOKLYN MED

CLINIC

Brooklyn Poweshiek Closed -

Declined

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Not

Available

PEOPLES

COMMUNITY

HEALTH CLINIC

Waterloo Black Hawk Closed -

Intake Only

Not

Available

EIMC Cedar

Rapids

Linn Closed -

Unreachable

Not

Available

UNITY POINT EAST

DES MOINES

Des Moines Polk Closed -

Declined

Not

Available

Covenant Waterloo Black Hawk Closed -

Unreachable

Not

Available

Prior Authorization Des Moines Polk Closed -

Unreachable

Not

Available

Shenandoah Medical

Center

King Scott Shenandoah Page Closed -

Enrolled

Not

Available

Prior Authorization Closed -

Unreachable

Not

Available

Prior Authorization DES

MOINES

Polk Closed -

Unreachable

Not

Available

Prior Authorization Des Moines Polk Closed -

Unreachable

Not

Available

Sanford Clinic Rock

Rapids

Roemen Rebecc

a

Inwood Lyon Closed -

Unreachable

Not

Available

SANFORD CLINIC

ROCK RAPIDS

Closed -

Duplicate

Not

Available

Sanford Clinic Rock

Rapids

Roemen Rebecc

a

Inwood Lyon Closed -

Unreachable

Not

Available

New Life Family

Medicine

Krogstad Karen Lenox Taylor Closed -

Unreachable

Not

Available

Prior Authorization Cedar

Rapids

Linn Closed -

Unreachable

Not

Available

Prior Authorization Carroll Carroll Closed -

Enrolled

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Not

Available

METHODIST

PHYSICIANS CLINIC

MCELDERR

Y

THOMA

S

Closed -

Declined

Not

Available

Mercy Medical

Center

Columbus

City

Louisa Closed -

Unreachable

Not

Available

Unknown Clinton Clinton Closed -

Enrolled

Not

Available

Eastern IA Health

Center

Cedar

Rapids

Linn Closed -

Unreachable

Not

Available

Prior Authorization Denison Crawford Closed -

Enrolled

Not

Available

UNITY POINT

CLINIC

Vinton Benton Closed -

Enrolled

Not

Available

Unity Point Family

Practice

Gapp April Fort Dodge Webster Closed -

Unreachable

Not

Available

Prior Authorization 7481

Highway

65/69

Young Sheryl Des Moines Polk Closed -

Unreachable

Not

Available

Community Health

Care

Closed -

Unreachable

Not

Available

Community Health

Plan

Davenport Scott Closed -

Enrolled

Not

Available

Community Health

Care

Davenport Scott Closed -

Intake Only

Not

Available

Mercy Family Care Klise Kurt Perry Dallas Closed -

Unreachable

Not

Available

METHODIST

PHYSICIANS CLINIC

Council

Bluffs

Pottawattami

e

Closed -

Unreachable

Not

Available

Prior Authorization Conesville Muscatine Closed -

Enrolled

Not

Available

Prior Authorization Marengo Iowa Closed -

Enrolled

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Not

Available

Prior Authorization Des Moines Polk Closed -

Intake Only

Not

Available

UIHU Muscatine Maharry Michael Lowden Cedar Closed -

Unreachable

Not

Available

Prior Authorization 500 W

River Dr

Davenpo

rt

Chana Davenport Scott Closed -

Enrolled

Not

Available

Douds Medical Clinic Kuder James Fairfield Jefferson Closed -

Enrolled

Not

Available

community health

care

barkley stephan

ie

Davenport Scott Closed -

Ineligible

Not

Available

EASTERN IOWA

HEALTH CTR

Cedar

Rapids

Linn Closed -

Enrolled

Not

Available

UNITY POINT

CLINIC

Belle Plaine Benton Closed -

Enrolled

Not

Available

Peoples Community

Health Clinic

Closed -

Unreachable

Not

Available

PEOPLES

COMMUNITY

HEALTH CLINIC

Closed -

Unreachable

Not

Available

NORTHEAST LA

FAMILY PRACTICE

Waterloo Black Hawk Closed -

Unreachable

Not

Available

Peoples Community

Health Clinic

Waterloo Black Hawk Closed -

Intake Only

Not

Available

COVENANT CLINIO Oelwein Fayette Closed -

Unreachable

Not

Available

Southglen Family

Medicine Unity Point

Des Moines Polk Closed -

Enrolled

Not

Available

UNITY POINT

SOUTHGLEN CLINC

Closed -

Already

Participating

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Not

Available

VILLISCA FAM

HEALTH CTR

Red Oak Montgomery Closed -

Declined

Not

Available

Prior Authorization Spirit Lake Dickinson Closed -

Enrolled

Not

Available

Prior Authorization Mason City Cerro Gordo Closed -

Unreachable

Not

Available

GUNDERSEN

HEALTH

CONNELLY BARRY New Albin Allamakee Closed -

Enrolled

Not

Available

McFanand Clinic Roodd Megan Marshalltow

n

Marshall Closed -

Unreachable

Not

Available

MERCY FAMILY

MEDICINE

RESIDENCY CLINIC

MOORE CHRIST

OPHER

Mason City Cerro Gordo Closed -

Unreachable

Not

Available

Methodist Physicians

Clinic

Council

Bluffs

Pottawattami

e

Closed -

Unreachable

Not

Available

PRIMARY HEALTH

CARE

State Center Marshall Closed -

Unreachable

Not

Available

Peoples Community

Health Clinic

Waterloo Black Hawk Closed -

Unreachable

Not

Available

IRL East Family

Medicine

Shaik Shalina Fairfax Linn Closed -

Enrolled

Not

Available

EASTERN IOWA

HEALTH CENTER

W Amy Closed -

Unreachable

Not

Available

UNITY POINT

CLINIC FAM MED

NORTH PORT

Muscatine Muscatine Closed -

Unreachable

Not

Available

university of ia hospt

and clinic

Clinton Clinton Closed -

Enrolled

Not

Available

COMMUNITY

HEALTH CARE

Davenport Scott Closed -

Intake Only

Not

Available

Atkins Family Medical

Center

Vinton Benton Closed -

Unreachable

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Not

Available

Prior Authorization 2605 SW

White

Birch

Drive

Ankeny Zea Erin Ankeny Polk Closed -

Enrolled

Not

Available

Prior Authorization 1010 4th

Street

SW,

Suite 340

Mason

City

Kuhn Hayley Mason City Cerro Gordo Closed -

Intake Only

Not

Available

Eastern Iowa Health

Center

Hiawatha Linn Closed -

Unreachable

Not

Available

CHC Davenport Scott Closed -

Unreachable

Not

Available

Mercy Family

Residency

Jewell Brianna Garner Hancock Closed -

Unreachable

Not

Available

Prior Authorization Clarence Cedar Closed -

Unreachable

Not

Available

Prior Authorization Laurens Pocahontas Closed -

Enrolled

Not

Available

Prior Authorization Liscomb Marshall Closed -

Unreachable

Not

Available

Unity Point Southglen Young Sheryl Des Moines Polk Closed -

Unreachable

Not

Available

HCHC Physicians

and Clinics

Bonnesen Kendra New London Henry Closed -

Already

Participating

Not

Available

HCHC Physicians

and Clinics

Bonnesen Kendra New London Henry Closed -

Already

Participating

Not

Available

OB GYN

ASSOCIATES

Cedar

Rapids

Linn Closed -

Unreachable

Not

Available

Mercy Family Clinic

Clear lake

Jones Anne Clear Lake Cerro Gordo Closed -

Unreachable

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Not

Available

Peoples Clinic Butler

County

Duclos Sharon Evansdale Black Hawk Closed -

Enrolled

Not

Available

MERCYCARE MED

DISTRICT

Cedar

Rapids

Linn Closed -

Unreachable

Not

Available

COUENANT CLINIC

PULMONOLOGY

Nashua Chickasaw Closed -

Unreachable

Not

Available

EIHC Schabillion Rose Cedar

Rapids

Linn Closed -

Unreachable

Not

Available

Prior Authorization Logan Harrison Closed -

Declined

Not

Available

COMMUNITY

HEALTH CARE

Closed -

Duplicate

Not

Available

COMMUNITY

HEALTH CARE

Davenport Scott Closed -

Enrolled

Not

Available

PEOPLES

COMMUNITY

HEALTH CLINIC

Waterloo Black Hawk Closed -

Ineligible

Not

Available

OPTHALMOLOGY IA

RIVER LANDING

Conesville Muscatine Closed -

Unreachable

Not

Available

Primary Health Care Dale Allen Marshalltow

n

Marshall Closed -

Unreachable

Not

Available

Eastern Iowa Health

Center

Thatcher Brian Cedar

Rapids

Linn Closed -

Ineligible

Not

Available

Unity Point Clinic Palstrud Steven Muscatine Muscatine Closed -

Enrolled

Not

Available

COVERIAN CLINIC Oelwein Fayette Closed -

Intake Only

Not

Available

MENYCARE

MARION

Cedar

Rapids

Linn Closed -

Unreachable

Not

Available

Primary Health Care Clendening Debora

h

Marshalltow

n

Marshall Closed -

Unreachable

Not

Available

Prior Authorization Coralville Johnson Closed -

Enrolled

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Not

Available

Prior Authorization Oskaloosa Mahaska Closed -

Unreachable

Not

Available

Prior Authorization Stroshal Kasey Ames Story Closed -

Invalid

Not

Available

Prior Authorization Famuyid Victoria DUBUQUE Dubuque Closed -

Intake Only

Not

Available

Peoples Community

Health Clinic

Singh Baljit Waterloo Black Hawk Closed -

Unreachable

Not

Available

Peoples Community

Health Clinic

Singh Bayit Waterloo Black Hawk Closed -

Duplicate

Not

Available

Women's Health

Services

Clinton Clinton Closed -

Unreachable

Not

Available

EASTERN IA

HEALTH CTR

Cedar

Rapids

Linn Closed -

Intake Only

Not

Available

Lucas County Health

Center

Chariton Lucas Closed -

Enrolled

Not

Available

Prior Authorization Osceola Clarke Closed -

Enrolled

Not

Available

Prior Authorization Des Moines Polk Closed -

Enrolled

Not

Available

Prior Authorization Davenport Scott Closed -

Enrolled

Not

Available

Prior Authorization Douds Van Buren Closed -

Declined

Not

Available

Prior Authorization Mount

Vernon

Linn Closed -

Unreachable

Not

Available

Prior Authorization New

Hartford

Butler Closed -

Intake Only

Not

Available

Prior Authorization Akron Plymouth Closed -

Unreachable

Not

Available

Prior Authorization Davenport Scott Closed -

Unreachable

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Not

Available

Community Health

Care

Metuge Anee Davenport Scott Closed -

Unreachable

Not Available

CHI CLINIC CRESTON Union Closed -

Unreachable

Not Available

CHI CLINIC Closed -

Duplicate

Not Available

FAM MED WEST

DES MOINES

West Des

Moines

Polk Closed -

Enrolled

Not Available

Mason City Clinic Mason City Cerro Gordo Closed -

Unreachable

Not Available

Burgess Family Clinic Walker Chad Castana Monona Closed -

Unreachable

Not

Available

Mercy Care Cedar

Rapids

Linn Closed -

Enrolled

Not

Available

Community Health

Care

Davenport Scott Closed -

Unreachable

Not

Available

Convenient Care Waterloo Black Hawk Closed -

Unreachable

Not

Available

Prior Authorization Sigourney Keokuk Closed -

Unreachable

Not

Available

Prior Authorization Livermore Dr Cedar

Rapids

Linn Closed -

Unreachable

Not

Available

Prior Authorization George

Paulson

Leslie Scott Closed -

Intake Only

Not

Available

Prior Authorization Hajj Kathy Council

Bluffs

Pottawattami

e

Closed -

Unreachable

Not

Available

Regional Health

Center

Geneva Franklin Closed -

Declined

Not

Available

Prior Authorization Lohrville Calhoun Closed -

Unreachable

Not

Available

Prior Authorization Davenport Scott Closed -

Intake Only

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Not

Available

Wankon Gundersen

Health

Connelly Darey Luana Clayton Closed -

Enrolled

Not

Available

Medical Clinic P.C. Zanker Jaylene Hamburg Fremont Closed -

Enrolled

Not

Available

Eastern Iowa Health

Center

Schabilion Rose CEDAR

RAPIDS

Linn Closed -

Intake Only

Not

Available

community health

care

Davenport Scott Closed -

Intake Only

Not

Available

Medical Ass. Low Moor Clinton Closed -

Intake Only

Not

Available

Community Health

Care

Chana Dr Davenport Scott Closed -

Enrolled

Not

Available

Mercy Family Care-

Perry

Noble Jason Woodward Dallas Closed -

Enrolled

Not

Available

Clarinda Medical

Associates

Schmadeke Thomas Clarinda Page Closed -

Intake Only

Not

Available

Prior Authorization Davenport Scott Closed -

Enrolled

Not

Available

Prior Authorization Closed -

Unreachable

Not

Available

Community Health

Care

Jauron Sarah Davenport Scott Closed -

Declined

Not

Available

MERCY WEST FAM

PRACTICE

Johnston Polk Closed -

Unreachable

Not

Available

Unity Point Clinic Fults Angela Belle Plaine Benton Closed -

Duplicate

Page Shenandoah

Physcians Clinic

51601 Holmes Connie Westboro Atchison Closed -

Unreachable

Page Clarinda Medical

Associates

51632 Furst Talisha Braddyville Page Closed -

Unreachable

Palo Alto Palo Alto County

Hospital

3201 1st

St

Emmets

burg

50536 Houge Amber Emmetsburg Closed -

Enrolled

Palo Alto Palo Alto County

Hospital

3201 1st

St

Emmets

burg

50536 Houge Amber Emmetsburg Closed -

Unreachable

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Palo Alto Family Practice Clinic 3201 1st

Street

Emmets

burg

50536 Houge Amber Emmetsburg Closed -

Enrolled

Palo Alto Family Practice Clinic 50536 Getta Thomas Ayrshire Palo Alto Closed -

Enrolled

Palo Alto PALO ALTO

COUNTY HOSPITAL

FAMILY PRACTICE

50536 H AMBER Emmetsburg Palo Alto Closed -

Enrolled

Polk Unity Point Family

Medical, Altoona

Francisco Laura Altoona Polk Closed -

Unreachable

Polk Prior Authorization Mercy

East

Village -

1350 Des

Moines

Street

Des

Moines

50309 Mein Lorene Des Moines Polk Closed -

Unreachable

Polk Prior Authorization 5615 NW

86th

Street

Johnsto

n

50131 Heck Barbara Madrid Boone Closed -

Intake Only

Polk Prior Authorization 1801

Hickman

Road

Des

Moines

50314 Hanson Douglas Des Moines Polk Closed -

Enrolled

Polk Prior Authorization 2720 8th

Street

SW

Altoona 50009 Harvey Julia MITCHELLV

ILLE

Polk Closed -

Invalid

Polk Prior Authorization 7481

Hwy

65169

DeMoine

s

50320 Shahid Saima Des Moines Polk Closed -

Unreachable

Polk DMU Clinic 3200

Grand

Ave

DSM 50312 Vargus April Des Moines Polk Closed -

Declined

Polk Broadlawns Internal

Medicine

50314 Maigaard Randy Des Moines Polk Closed -

Declined

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Polk Prior Authorization 6601 SW

9th

Street

Des

Moines

50315 Nordstrom Lindy Des Moines Polk Closed -

Invalid

Polk Mercy Urbandale 50322 Alarcon Carlos Des Moines Polk Closed -

Unreachable

Polk Prior Authorization 320

Watson

Powell Jr

Way

Des

Moines

50309 Steinmann Lori Des Moines Polk Closed -

Enrolled

Polk Prior Authorization 2720 8th

St SW

Altoona 50009 Harvey Julia MITCHELLV

ILLE

Polk Closed -

Invalid

Polk Primary Health Care Flug Ryan Des Moines Polk Closed -

Enrolled

Polk Southglen Unity Point 50320 Shahid Saima Ankeny Polk Closed -

Already

Participating

Polk Southglen Family

Medicine Unity Point

50320 Shahid Saima Des Moines Polk Closed -

Unreachable

Polk Primary Healthcare

Engebretsen Clinic

50320 Flug Ryan Des Moines Polk Closed -

Enrolled

Polk Primary Health Care 50320 Flug Ryan Des Moines Polk Closed -

Intake Only

Pottawattami

e

METHODIST

JENNIE EDMUNSON

HOSPT

Council

Bluffs

Pottawattami

e

Closed -

Unreachable

Pottawattami

e

Methodist Jennie

Edmundson

Council

Bluffs

Pottawattami

e

Closed -

Enrolled

Pottawattami

e

METHODIST

JENNIE

EDMUNDSON

HOSPITAL

Council

Bluffs

Pottawattami

e

Closed -

Declined

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Pottawattami

e

Methodist Jennie

Edmundson Hospital

51503 Sheppard Kevin Council

Bluffs

Pottawattami

e

Closed -

Unreachable

Pottawattami

e

Methodist Jennie

Edmundson Hospital

51503 Sheppard Kevin Council

Bluffs

Pottawattami

e

Closed -

Duplicate

Pottawattami

e

Prior Authorization 1701

West

Broadwa

y

Council

Bluffs

51501 Badalucco Laura Council

Bluffs

Pottawattami

e

Closed -

Unreachable

Pottawattami

e

Prior Authorization 1701

West

Broadwa

y

Council

Bluffs

51501 Badalucco Laura Council

Bluffs

Pottawattami

e

Closed -

Unreachable

Pottawattami

e

Jennie Edmundson

Hospital

933 East

Pierce st

Council

Bluffs

51503 Marar Dr. Council

Bluffs

Closed -

Unreachable

Pottawattami

e

Methodist Jennie

Edmundson Hospital

51503 Frazzle Dannie Red Oak Montgomery Closed -

Unreachable

Pottawattami

e

Methodist Jennie

Edmundson Hospital

51503 Angela

Vogel /

Steven

Hart /

Rachel

Stearne

s

Council

Bluffs

Pottawattami

e

Closed -

Enrolled

Pottawattami

e

Jody Reese 902 S 6th

st

Council

Bluffs

51501 Reese Jodi Council

Bluffs

Pottawattami

e

Closed -

Unreachable

Pottawattami

e

Methodist Jeniie

Edmundson Hospital

Glenwood Mills Closed -

Enrolled

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Pottawattami

e

Methodist Jennie

Edmudson Hospital

Walnut Pottawattami

e

Closed -

Unreachable

Pottawattami

e

Methodist Jennie

Edmundson Hospital

Council

Bluffs

Pottawattami

e

Closed -

Unreachable

Pottawattami

e

Methodist Jennie

Edmundson Hospital

Comke Dr Z Persia Harrison Closed -

Unreachable

Pottawattami

e

Methodist Jenni

Edmundson Hosp

51503 Council

Bluffs

Pottawattami

e

Closed -

Intake Only

Pottawattami

e

Methodist Jennie

Edumndson

51503 Council

Bluffs

Pottawattami

e

Closed -

Current

Appointment

Pottawattami

e

Methodist Jennie

Edmundson Hospital

51503 Madson C Council

Bluffs

Pottawattami

e

Closed -

Unreachable

Pottawattami

e

Methodist Jennie

Edundson Hospital

51503 Woltemath Hamburg Fremont Closed -

Enrolled

Pottawattami

e

Methodist Jennie

Edmundson Hospital

51503 Sheppard Council

Bluffs

Pottawattami

e

Closed -

Intake Only

Pottawattami

e

Methodist Jennie

Edmundson Hospital

Marquardt R Elk Horn Shelby Closed -

Unreachable

Pottawattami

e

Methodist Jennie

Edmundson

933 East

Pierce

Council

Bluffs

51503 Marar Dr Council

Bluffs

Closed -

Unreachable

Pottawattami

e

Methodist Jennie

Hosp

Villisca Montgomery Closed -

Unreachable

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Pottawattami

e

Methodist Jennie

Edmundson Hospital

51503 Hanson Dr Council

Bluffs

Pottawattami

e

Closed -

Already

Participating

Pottawattami

e

Methodist Jennie

Edmundson Hospital

51503 Thippareddi S Council

Bluffs

Pottawattami

e

Closed -

Unreachable

Pottawattami

e

Methodist Jennie

Edmundson Hospital

51503 Issacson Todd Shenandoah Page Closed -

Unreachable

Pottawattami

e

Methodist Physicians

Clinic

51503 Council

Bluffs

Pottawattami

e

Closed -

Unreachable

Pottawattami

e

Methodist Physician

Clinic

51503 McElderry Thomas Crescent Pottawattami

e

Closed -

Declined

Pottawattami

e

Allcare Health Center 51501 Dowling Teresa Council

Bluffs

Pottawattami

e

Closed -

Enrolled

Pottawattami

e

All Care Health

Center

51501 Swampillai Aruntha Council

Bluffs

Pottawattami

e

Closed -

Unreachable

Pottawattami

e

CHI - West Broadway

Clinic

51501 Hill Krista Carter Lake Pottawattami

e

Closed -

Unreachable

Pottawattami

e

CHI Oakland 51560 Bridges Constan

ce

Shelby Shelby Closed -

Unreachable

Pottawattami

e

CHI Oakland 51560 Bridges Constan

ce

Shelby Shelby Closed -

Current

Appointment

Pottawattami

e

Methodist Physicians

Clinic

51503 McElderry Thomas Council

Bluffs

Pottawattami

e

Closed -

Unreachable

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Pottawattami

e

Methodist Physician

Clinic

51503 McCool Jessica Carter Lake Pottawattami

e

Closed -

Ineligible

Pottawattami

e

Methodist 51503 Jones Christia

n

Council

Bluffs

Pottawattami

e

Closed -

Duplicate

Pottawattami

e

Methodist Physician's

Clinic

51503 Tymkowych Nadia Council

Bluffs

Pottawattami

e

Closed -

Duplicate

Ringgold Mount Ayr Medical

Clinic

50854 Ricker Bruce Creston Union Closed -

Unreachable

Sac Unity Point Clinic 109

Green St

Lake

View

51450 Blessington Kay Ida Grove Ida Closed -

Ineligible

Scott Prior Authorization 1345

West

Central

Park

Davenpo

rt

52804 Davis Dr Davenport Scott Closed -

Unreachable

Scott Prior Authorization 1345

West

Central

Park

Davenpo

rt

52803 Cavey Andrea DAVENPOR

T

Scott Closed -

Unreachable

Scott Unity Point Fam Med 4311 E

53rd St

Davenpo

rt

52807 Kolner Ben Davenport Closed -

Declined

Scott Prior Authorization 301

North 4th

Avenue

Eldridge 52748 Cloos Carla Eldridge Scott Closed -

Enrolled

Scott Prior Authorization 1820

West 3rd

Street

Davenpo

rt

52802 Cone Regan Closed -

Unreachable

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Scott UnityPoint Clinic

Family Medicine 53rd

Street

4311 E

53rd

Street

Davenpo

rt

52807 Aanestad Jennifer Davenport Closed -

Unreachable

Scott Prior Authorization 2140

53rd

Avenue

Bettendo

rf

52722 Salowitz Stacie Davenport Scott Closed -

Declined

Scott Prior Authorizations 2140

53rd

Avenue

Bettendo

rf

52722 Salowitz Stacie Davenport Scott Closed -

Intake Only

Scott Community Health

Care

52801 Barkley Stephan

ie

Davenport Scott Closed -

Already

Participating

Scott Community

Healthcare

52801 Misiag Ashlee Davenport Scott Closed -

Enrolled

Scott Community Health

Care

52801 Besch Dr Davenport Scott Closed -

Enrolled

Scott Pulmonary

Associates

52807 Wong Humphr

ey

Davenport Scott Closed -

Unreachable

Scott Community

Healthcare

52801 Bosch Jacklyn Davenport Scott Closed -

Unreachable

Scott COMMUNITY

HEALTH CARE

500

WEST

RIVER

DR

52801 CHARA Davenport Scott Closed -

Unreachable

Scott Waterford Family

Medicine

52807 Paisley Alisa Davenport Scott Closed -

Already

Participating

Scott Community Health

Care

52801 Barkley Stephan

ie

Davenport Scott Closed -

Enrolled

Shelby Prior Authorization 1220

Chatburn

Ave

Harlan 51537 Heileson Bret HARLAN Shelby Closed -

Invalid

Story McFarland Clinic 50010 Calland Kristy Woodward Dallas Closed -

Unreachable

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Tama Prior Authorization 401 1st

Avenue

Toledo 52342 Parks Sherry Toledo Tama Closed -

Unreachable

Tama Prior Authorization 402

Siegel

Street

Tama 52339 Wille Jerry Tama Tama Closed -

Enrolled

Taylor Lenox Medical Clinic 100 S

Mian St

Lenox 50851 Rubenking Darcy Creston Closed -

Enrolled

Union Greater Regional

Clinic

1610 W

Townline

#200

Creston 50801 Miller Lonny Creston Union Closed -

Unreachable

Van Buren Prior Authorization 304

Franklin

St

Keosaug

ua

52565 Keeder James Douds Van Buren Closed -

Intake Only

Van Buren VBCH Bonaparte

Blinic

52620 Nank Kelsey Farmington Van Buren Closed -

Unreachable

Van Buren Douds Medical Clinic 52551 Kuder James Birmingham Van Buren Closed -

Enrolled

Van Buren Birmingham Rural

Health Clinic

52535 Striegel BeLinda Birmingham Van Buren Closed -

Intake Only

Van Buren Douds Medical Clinic 52551 Kuder James Douds Van Buren Closed -

Current

Appointment

Wapello Prior Authorization 107

North 3rd

Street

Eddyville 52553 Bechtel Shelley Eddyville Wapello Closed -

Enrolled

Wapello Prior Authorization 107 N

3rd St

Eddyviell

e

52553 Bechtel Shelley Kirkville Wapello Closed -

Enrolled

Wapello Prior Authorization 107

North 3rd

Street

Eddyville 52553 Bechtel Shelley Eddyville Wapello Closed -

Enrolled

County Clinic Name Clinic

Address

Clinic

City

Clinic

Zip

Code

Referred By

Last Name

Referre

d By

First

Participant

City

Participant

County

Status

Wapello Prior Authorization 1013

Pennsylv

ania

Avenue

Ottumwa 52501 Dawson Shawn New Sharon Mahaska Closed -

Unreachable

Webster Prior Authorization 126 N

10th St

Fort

Dodge

50501 Zigrang Jennifer FORT

DODGE

Webster Closed -

Unreachable

Webster PRIMARY

HEALTHCARE

50518 Swinton Tim Toledo Tama Closed -

Unreachable

Webster Unity Point Family 50501 Gapp April Closed -

Already

Participating

Winnebago Mercy Family Clinic Lake

Mills

50450 Keller Pamela Lake Mills Winnebago Closed -

Unreachable

Winnebago Mercy Family Clinic Lake

Mills

50450 Keller Lake Mills Winnebago Closed -

Declined

Winnebago Prior Authorization 635 East

Highway

9

Forest

City

50436 Carlson Byron Forest City Winnebago Closed -

Intake Only

Winnebago Mercy Family Clinich Buffalo

Center

50424 Carlson Byron Buffalo

Center

Winnebago Closed -

Enrolled

Woodbury Mercy Medical

Center Sioux City

801 5th

St

Sioux

City

51101 Paugh Brian Sioux City Woodbury Closed -

Unreachable

Woodbury Mercy Medical

Center

51102 Sioux City Woodbury Closed -

Already

Participating

Woodbury Mercy Medical

Center Sioux City

51102 Sioux City Woodbury Closed -

Unreachable

Woodbury FAMILY NEDICINE

CENTER

51104 PALLONE DR

STEPH

EN

Sioux City Woodbury Closed -

Already

Participating

Wright Hayley Kuhn 1010 4th

St Ste

340

Mason

City

50101 Closed -

Intake Only