Healthcare Provider Details

I. General information

NPI: 1891533022
Provider Name (Legal Business Name): JAMES W MONCHERRY PHD, CNA, PBT, PMU-P
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2024
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 SE LAUREL ST
WAUKEE IA
50263-8262
US

IV. Provider business mailing address

2680 ADOBE DR
WAUKEE IA
50263-7119
US

V. Phone/Fax

Practice location:
  • Phone: 515-556-3518
  • Fax:
Mailing address:
  • Phone: 515-556-3518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberTAT-A-3659
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: