Provider Demographics
NPI:1275530370
Name:MOHR, JOY S (PA-C)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:S
Last Name:MOHR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 220TH TRL
Mailing Address - Street 2:
Mailing Address - City:AMANA
Mailing Address - State:IA
Mailing Address - Zip Code:52203-8244
Mailing Address - Country:US
Mailing Address - Phone:319-622-2911
Mailing Address - Fax:
Practice Address - Street 1:122 1/2 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MARENGO
Practice Address - State:IA
Practice Address - Zip Code:52301-1503
Practice Address - Country:US
Practice Address - Phone:319-759-9721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001323363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP14648Medicare UPIN