NPIMap

Organization Active NPI

Medical Center Anesthesiologists, P.C.

  • Anesthesiology Physician
  • West Des Moines, IA
National Provider Identifier
1073552428
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
MEDICAL CENTER ANESTHESIOLOGISTS, P.C.
Practice address
1225 Jordan Creek Pkwy Ste 180
West Des Moines, IA 50266-2346
Phone
(515) 283-0463
Fax
(515) 283-0794
NPI assigned
Jun 4, 2006
Last updated
Nov 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Authorized official

Name
Carrie Johnson
Title
Director of Administration
Phone
(515) 513-3266

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X NU

Addresses

Primary practice location

1225 Jordan Creek Pkwy Ste 180
West Des Moines, IA 50266-2346

Mailing address

1225 Jordan Creek Pkwy Ste 180
West Des Moines, IA 50266-2346
Phone (515) 283-0463

Other identifiers 1

IdentifierTypeStateIssuer
0041889MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031112000714 IA Part B Supplier - Clinic/Group Practice 4082527270 Receives reassigned benefits from 86 practitioners
1 other NPI on this enrollment
Practice locations: Clive, IA; West Des Moines, IA; Pleasant Hill, IA; Newton, IA; Des Moines, IA; Ankeny, IA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1225 Jordan Creek Pkwy
Ste 180
West Des Moines, IA 50266
Phone (515) 283-0463

1755 59th Pl
West Des Moines, IA 50266
Phone (515) 247-4240

Practitioners & affiliated clinicians

Practitioners 113

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 113

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762992000000",
    "number": "1073552428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 JORDAN CREEK PKWY STE 180",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502662346",
            "telephone_number": "515-283-0463",
            "fax_number": "515-283-0794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 JORDAN CREEK PKWY STE 180",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502662346",
            "telephone_number": "515-283-0463",
            "fax_number": "515-283-0794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTER ANESTHESIOLOGISTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "DIRECTOR OF ADMINISTRATION",
        "authorized_official_telephone_number": "515-513-3266"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0041889",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.