Healthcare Provider Details

I. General information

NPI: 1689724676
Provider Name (Legal Business Name): JOSETTE E. GORDON-SIMET M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1288 VALLEY VIEW DR
COUNCIL BLUFFS IA
51503-5245
US

IV. Provider business mailing address

1288 VALLEY VIEW DR
COUNCIL BLUFFS IA
51503-5245
US

V. Phone/Fax

Practice location:
  • Phone: 712-328-8800
  • Fax: 712-328-8461
Mailing address:
  • Phone: 712-328-8800
  • Fax: 712-328-8461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-53031
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number21590
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: