NPIMap

Organization Active NPI

Western Iowa Surgery Inc

  • Surgery Physician
  • Carroll, IA
National Provider Identifier
1073713111
Registry record updated Oct 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
02944 Issued in IA
Legal business name
WESTERN IOWA SURGERY INC
Practice address
311 S Clark St
Suite 280
Carroll, IA 51401-3038
Phone
(712) 792-0480
Fax
(712) 792-1318
NPI assigned
Jul 18, 2007
Last updated
Oct 21, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2011

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

Authorized official

Name
Teresa Cullen
Title
Office Manager
Phone
(712) 792-0480

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 02944 IA Primary

Addresses

Primary practice location

311 S Clark St
Suite 280
Carroll, IA 51401-3038

Mailing address

311 S Clark St
Suite 280
Carroll, IA 51401-3038
Phone (712) 792-0480

Other identifiers 1

IdentifierTypeStateIssuer
0451435MedicaidIA

National Provider Directory

National Provider Directory

Locations

410 Main St
Manning, IA 51455
Phone (712) 655-2072

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319155200000",
    "number": "1073713111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 S CLARK ST",
            "address_2": "SUITE 280",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514013038",
            "telephone_number": "712-792-0480",
            "fax_number": "712-792-1318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 S CLARK ST",
            "address_2": "SUITE 280",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514013038",
            "telephone_number": "712-792-0480",
            "fax_number": "712-792-1318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN IOWA SURGERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-18",
        "last_updated": "2011-10-21",
        "status": "A",
        "authorized_official_last_name": "CULLEN",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "712-792-0480"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "02944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0451435",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carroll, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2011; 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.