NPIMap

Organization Active NPI

Central Iowa Hospital Corporation

Doing business as East Des Moines Family Care Center

  • Family Medicine Physician
  • Des Moines, IA
National Provider Identifier
1104879576
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CENTRAL IOWA HOSPITAL CORPORATION
Doing business as
East Des Moines Family Care Center
Practice address
840 E University Ave
Des Moines, IA 50316-2304
Phone
(515) 265-4211
Fax
(515) 309-5993
NPI assigned
May 18, 2006
Last updated
Mar 19, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTRAL IOWA HOSPITAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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

Authorized official

Name
Michael J Dewerff
Title
Cfo
Phone
(515) 241-6507

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X
Clinical Social Worker 1041C0700X
Family Medicine Physician 207Q00000X Primary
Obstetrics & Gynecology Physician 207V00000X
Radiation Oncology Physician 2085R0001X

Addresses

Primary practice location

840 E University Ave
Des Moines, IA 50316-2304

Mailing address

5409 NW 88TH St
Suite 200
Johnston, IA 50131-2949
Phone (515) 362-5980

Other identifiers 2

IdentifierTypeStateIssuer
0096958MedicaidIA
CC7397OtherIARAILROAD MEDICARE GROUP

Other names 1

  • East Des Moines Family Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040128001102 IA Part B Supplier - Clinic/Group Practice 1052229275 Receives reassigned benefits from 561 practitioners
20 other NPIs on this enrollment

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 20

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

View all 20

National Provider Directory

National Provider Directory
Part of
Unity Point Health Blank Childrens Hospital

Locations

855 A Ave NE
Ste 310
Cedar Rapids, IA 52402
Phone (319) 558-4876

1111 6th Ave
Fl 3
Des Moines, IA 50314

1200 Pleasant St
#206
Des Moines, IA 50309
Phone (515) 241-5100

1200 Pleasant St
#P
Des Moines, IA 50309

1200 Pleasant St
#S228
Des Moines, IA 50309
Phone (515) 241-4200

1200 Pleasant St
Ste 303
Des Moines, IA 50309

1206 Pleasant St
#2
Des Moines, IA 50309
Phone (515) 241-6465

1206 Pleasant St
Fl 1
Des Moines, IA 50309

1212 Pleasant St
Ste 116
Des Moines, IA 50309

1212 Pleasant St
Ste 204
Des Moines, IA 50309
Phone (515) 241-6542

1215 Pleasant St
Ste 3
Des Moines, IA 50309

1221 Pleasant St
Ste 250
Des Moines, IA 50309
Phone (515) 241-4674

1250 E 9th St
Ste 200
Des Moines, IA 50316
Phone (515) 263-2632

1301 Penn Ave
Ste 406
Des Moines, IA 50316
Phone (515) 263-2412

1301 Pennsylvania Ave
Ste 305
Des Moines, IA 50316
Phone (515) 263-4004

3116 Carpenter Ave
Des Moines, IA 50311
Phone (515) 271-3731

4020 Merle Hay Rd
Des Moines, IA 50310
Phone (515) 278-0949

202 4th Ave
Grinnell, IA 50112
Phone (641) 236-2008

4755 Parkridge Ave
Pleasant Hill, IA 50327
Phone (515) 265-5348

1300 37th St
West Des Moines, IA 50266
Phone (515) 224-4711

Ownership & related parties

All facility ownership & control disclosures 27

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Guthrie County HospitalGuthrie Center, IA, CCN 161314 Hospital Operational/Managerial Control Jan 1, 2014
Clarke County HospitalOsceola, IA, CCN 161348 Hospital Operational/Managerial Control Dec 1, 1987
Lucas County Health CenterChariton, IA, CCN 161341 Hospital Operational/Managerial Control Sep 1, 2015
Guthrie County HospitalGuthrie Center, IA, CCN 16Z314 Hospital Operational/Managerial Control Jan 1, 2014
Clarke County HospitalOsceola, IA, CCN 16Z348 Hospital Operational/Managerial Control Dec 1, 1987
Greater Regional Medical CenterCreston, IA, CCN 161365 Hospital Operational/Managerial Control Jul 1, 2017
Greater Regional Medical CenterCreston, IA, CCN 16Z365 Hospital Operational/Managerial Control Jul 1, 2017
Lucas County Health CenterChariton, IA, CCN 16Z341 Hospital Operational/Managerial Control Sep 1, 2015
Greene County Medical CenterJefferson, IA, CCN 161325 Hospital Operational/Managerial Control Jul 1, 2011
Unitypoint Health Des Moines Iowa Methodist Medical CenterDes Moines, IA, CCN 160082 Hospital Other Jun 22, 1982
Unitypoint Health Des Moines Iowa Methodist Medical CenterDes Moines, IA, CCN 16T082 Hospital Other Jun 22, 1982
Story County Medical CenterNevada, IA, CCN 161333 Hospital Operational/Managerial Control Feb 1, 2013
Story County Medical CenterNevada, IA, CCN 16Z333 Hospital Operational/Managerial Control Feb 1, 2013
Greene County Medical CenterJefferson, IA, CCN 16Z325 Hospital Operational/Managerial Control Jul 1, 2011
Unitypoint Health Des Moines Iowa Lutheran HospitalDes Moines, IA, CCN 16S082 Hospital Other Jun 22, 1982
Cedar Ridge VillageWest Des Moines, IA, CCN 165790 Skilled nursing facility Direct Ownership Interest (47.47%) Apr 1, 2021
Lenox Medical ClinicLenox, IA, CCN 163469 Rural health clinic Operational/Managerial Control Jul 1, 2017
Lucas County Health Center Medical ClinicChariton, IA, CCN 168560 Rural health clinic Operational/Managerial Control Sep 1, 2015
Story Medical Clinic - NevadaNevada, IA, CCN 168594 Rural health clinic Operational/Managerial Control Feb 1, 2013
Story Medical Clinic - MaxwellMaxwell, IA, CCN 168595 Rural health clinic Operational/Managerial Control Feb 1, 2013
Corning Medical ClinicCorning, IA, CCN 168636 Rural health clinic Operational/Managerial Control Jul 1, 2017
Mount Ayr Community Health ClinicMount Ayr, IA, CCN 168638 Rural health clinic Operational/Managerial Control Jul 1, 2017
Greene County Family MedicineJefferson, IA, CCN 168619 Rural health clinic Operational/Managerial Control Jul 1, 2011
Clarke County ClinicOsceola, IA, CCN 168618 Rural health clinic Operational/Managerial Control Dec 1, 1987
GCH ClinicsAdair, IA, CCN 168620 Rural health clinic Operational/Managerial Control Jan 1, 2014
GCH ClinicsStuart, IA, CCN 168632 Rural health clinic Operational/Managerial Control Jan 1, 2014
GCH ClinicsPanora, IA, CCN 168637 Rural health clinic Operational/Managerial Control Jan 1, 2014

Owned or controlled facilities with NPI records 29

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 29

Practitioners & affiliated clinicians

Practitioners 585

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 585

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552953600000",
    "number": "1104879576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5409 NW 88TH ST",
            "address_2": "SUITE 200",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312949",
            "telephone_number": "515-362-5980",
            "fax_number": "515-362-5985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 E UNIVERSITY AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503162304",
            "telephone_number": "515-265-4211",
            "fax_number": "515-309-5993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL IOWA HOSPITAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRAL IOWA HOSPITAL CORPORATION",
        "enumeration_date": "2006-05-18",
        "last_updated": "2019-03-19",
        "status": "A",
        "authorized_official_last_name": "DEWERFF",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "515-241-6507"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0096958",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "CC7397",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Des Moines Family Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "East Des Moines Family Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.