NPIMap

Organization Active NPI

State University of Iowa

Doing business as Mission Cancer and Blood University of Iowa Health Care

  • Hematology & Oncology Physician
  • Des Moines, IA
National Provider Identifier
1104295823
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
STATE UNIVERSITY OF IOWA
Doing business as
Mission Cancer and Blood University of Iowa Health Care
Practice address
411 Laurel St
Suite 300a
Des Moines, IA 50314-3017
Phone
(515) 247-3970
Fax
(515) 663-8819
NPI assigned
Sep 23, 2015
Last updated
Jan 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Authorized official

Name
Mr. Joe M McKelvey Jr.
Title
Sr Director of Govt Reimbursement
Phone
(319) 467-8549

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RH0003X IA Primary

Addresses

Primary practice location

411 Laurel St
Suite 300a
Des Moines, IA 50314-3017

Mailing address

411 Laurel St Ste A300
Des Moines, IA 50314-3030
Phone (515) 282-2921

Other names 1

  • Mission Cancer and Blood University of Iowa Health Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151001002832 IA DME Supplier - Physician - General Practice 1254224876 Practice locations: Des Moines, IA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D0383693University of Iowa Health Care411 Laurel Street, Suite A300, Des Moines, IA 50314RegistrationJan 2, 2028

National Provider Directory

National Provider Directory
Tax ID family
Univ of Ia Hosps Clins57 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

Locations

1221 Pleasant St
Ste 540
Des Moines, IA 50309
Phone (515) 237-7030

608 SE Kent St
Greenfield, IA 50849
Phone (641) 743-2123

5950 University Ave
West Des Moines, IA 50266
Phone (515) 412-5112

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": "1442966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736812800000",
    "number": "1104295823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 LAUREL ST STE A300",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503143030",
            "telephone_number": "515-282-2921",
            "fax_number": "515-663-8819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 LAUREL ST",
            "address_2": "SUITE 300A",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503143017",
            "telephone_number": "515-247-3970",
            "fax_number": "515-663-8819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE UNIVERSITY OF IOWA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-23",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-13",
        "status": "A",
        "authorized_official_last_name": "MCKELVEY",
        "authorized_official_first_name": "JOE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SR DIRECTOR OF GOVT REIMBURSEMENT",
        "authorized_official_telephone_number": "319-467-8549",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mission Cancer and Blood University of Iowa Health Care",
            "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 Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.