Iowa City Plastic Surgery LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

IA-19759 Issued in IA

Legal business name

IOWA CITY PLASTIC SURGERY LLC

Practice address

501 12TH Ave
Suite 102
Coralville, IA 52241-1774

Phone

(319) 337-3740

NPI assigned

Mar 21, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Sandy M Brenneman

Title

Office Manager

Phone

(319) 337-3740

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Albert Cram, MD

  • Plastic and Reconstructive Surgery Physician
  • Coralville, IA
  • NPI 1841345279
  NPD (past)
• Claudette J Heddens, ARNP

  • Adult Health Nurse Practitioner
  • Coralville, IA
  • NPI 1982883336
  NPD (past)

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073572640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 12TH AVE",
            "address_2": "SUITE 102",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522411774",
            "telephone_number": "319-337-3740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 12TH AVE",
            "address_2": "SUITE 102",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522411774",
            "telephone_number": "319-337-3740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA CITY PLASTIC SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRENNEMAN",
        "authorized_official_first_name": "SANDY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "319-337-3740",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IA",
            "license": "IA-19759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Iowa CVS Pharmacy LLC
• Iowa Dental Health Professionals, P.C.
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• Iowa Eye Prosthetics, Inc.
• Iowa Medical & Classification Center

• Specialist in Coralville, IA
• Providers in Coralville, IA by specialty
• Specialist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.