NPIMap

Organization Active NPI

Iowa Physicians Clinic Medical Foundation

  • Durable Medical Equipment & Medical Supplies
  • Des Moines, IA
National Provider Identifier
1063448629
Registry record updated Aug 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
1100240056 Issued in IA
Legal business name
IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION
Practice address
7481 Highway 65 69
Des Moines, IA 50320-9613
Phone
(515) 953-1500
Fax
(515) 953-2136
NPI assigned
Jun 24, 2006
Organization subpart
Yes
Parent organization
IOWA PHYSICIANS CLINIC MEDICAL FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 16, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Erick J Laine
Title
Coo
Phone
(515) 471-9227

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 1100240056 IA Primary

Addresses

Primary practice location

7481 Highway 65 69
Des Moines, IA 50320-9613

Mailing address

8101 Birchwood Court
Suite R
Johnston, IA 50131-2930
Phone (515) 471-9243

Other names 1

  • Southglen Family Practice & UC Doing business as

National Provider Directory

National Provider Directory
Part of
Jeffrey Carandall MD

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345075200000",
    "number": "1063448629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 BIRCHWOOD COURT",
            "address_2": "SUITE R",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312930",
            "telephone_number": "515-471-9243",
            "fax_number": "515-471-9319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7481 HIGHWAY 65 69",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503209613",
            "telephone_number": "515-953-1500",
            "fax_number": "515-953-2136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION",
        "enumeration_date": "2006-06-24",
        "last_updated": "2012-08-16",
        "status": "A",
        "authorized_official_last_name": "LAINE",
        "authorized_official_first_name": "ERICK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "515-471-9227"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IA",
            "license": "1100240056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southglen Family Practice & UC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.