Central Iowa Hospital Corporation
Organization Active NPI Family Medicine Physician · Des Moines, IA
NPI 1104879576 · NPPES record last updated Mar 19, 2019
Key facts
- NPI
- 1104879576
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- CENTRAL IOWA HOSPITAL CORPORATION
- Practice address
- 840 E University Ave
Des Moines, IA 50316-2304 - Phone
- (515) 265-4211
- Fax
- (515) 309-5993
- NPI assigned
- May 18, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- CENTRAL IOWA HOSPITAL CORPORATION
Authorized official
- Name
- Michael J Dewerff
- Title
- Cfo
- Phone
- (515) 241-6507
Owned or controlled facilities with NPI records 29
Other NPIs on the same Medicare enrollment 20
Other NPIs with the same Medicare PAC ID 5
Practitioners 587
-
Deepika Reddy Abbadi, M.D
-
Blaire L Adams, AUD
-
Ahmad Alsalman, M.D.
-
Millicent Amankwah, M.D
-
Austin Tyler Baeth, M.D.
-
Laura L Baker, ARNP
-
Nicole Bales, ACNPC-AG
-
Sean Barrett, DO
-
Jill E Bartlett, ARNP
-
Kay Louise Beer, ARNP
-
Amy Elizabeth Blessing, LMSW
-
Samantha Bonin, DNP, AGACNP-BC
-
Daniel Simon Bor, MD
-
Dimitri Boreisha, DO
-
Tristan M Boss, ARNP
-
Natalie Bridge, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
All facility ownership & control disclosures 27
| Facility | Type | Role | Since |
|---|---|---|---|
| Guthrie County Hospital |
Hospital | Operational/Managerial Control | Jan 1, 2014 |
| Clarke County Hospital |
Hospital | Operational/Managerial Control | Dec 1, 1987 |
| Lucas County Health Center |
Hospital | Operational/Managerial Control | Sep 1, 2015 |
| Guthrie County Hospital |
Hospital | Operational/Managerial Control | Jan 1, 2014 |
| Clarke County Hospital |
Hospital | Operational/Managerial Control | Dec 1, 1987 |
| Greater Regional Medical Center |
Hospital | Operational/Managerial Control | Jul 1, 2017 |
| Greater Regional Medical Center |
Hospital | Operational/Managerial Control | Jul 1, 2017 |
| Lucas County Health Center |
Hospital | Operational/Managerial Control | Sep 1, 2015 |
| Greene County Medical Center |
Hospital | Operational/Managerial Control | Jul 1, 2011 |
| Unitypoint Health Des Moines Iowa Methodist Medical Center |
Hospital | Other | Jun 22, 1982 |
| Unitypoint Health Des Moines Iowa Methodist Medical Center |
Hospital | Other | Jun 22, 1982 |
| Story County Medical Center |
Hospital | Operational/Managerial Control | Feb 1, 2013 |
| Story County Medical Center |
Hospital | Operational/Managerial Control | Feb 1, 2013 |
| Greene County Medical Center |
Hospital | Operational/Managerial Control | Jul 1, 2011 |
| Unitypoint Health Des Moines Iowa Lutheran Hospital |
Hospital | Other | Jun 22, 1982 |
| Cedar Ridge Village |
Skilled nursing facility | Direct Ownership Interest (47.47%) | Apr 1, 2021 |
| Lenox Medical Clinic |
Rural health clinic | Operational/Managerial Control | Jul 1, 2017 |
| Lucas County Health Center Medical Clinic |
Rural health clinic | Operational/Managerial Control | Sep 1, 2015 |
| Story Medical Clinic - Nevada |
Rural health clinic | Operational/Managerial Control | Feb 1, 2013 |
| Story Medical Clinic - Maxwell |
Rural health clinic | Operational/Managerial Control | Feb 1, 2013 |
| Corning Medical Clinic |
Rural health clinic | Operational/Managerial Control | Jul 1, 2017 |
| Mount Ayr Community Health Clinic |
Rural health clinic | Operational/Managerial Control | Jul 1, 2017 |
| Greene County Family Medicine |
Rural health clinic | Operational/Managerial Control | Jul 1, 2011 |
| Clarke County Clinic |
Rural health clinic | Operational/Managerial Control | Dec 1, 1987 |
| GCH Clinics |
Rural health clinic | Operational/Managerial Control | Jan 1, 2014 |
| GCH Clinics |
Rural health clinic | Operational/Managerial Control | Jan 1, 2014 |
| GCH Clinics |
Rural health clinic | Operational/Managerial Control | Jan 1, 2014 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040128001102 | IA | Part B Supplier - Clinic/Group Practice | 1052229275 |
Receives reassigned benefits from 561 practitioners 20 other NPIs on this enrollment |
National Provider Directory
- Part of
- Methodist Hospital
Locations
204 8th St SE
Altoona, IA 50009
202 10th St SE
Ste 195
Cedar Rapids, IA 52403
Phone (319) 558-4876
1301 Pennsylvania Ave
Ste 305
Des Moines, IA 50316
Phone (515) 263-4004
1215 Pleasant St
Ste 3
Des Moines, IA 50309
1200 Pleasant St
#126
Des Moines, IA 50309
1440 Pleasant St
Des Moines, IA 50314
1440 Pleasant St
Ste 1
Des Moines, IA 50314
Phone (515) 241-8383
1200 Pleasant St
Ste 1
Des Moines, IA 50309
4020 Merle Hay Rd
Des Moines, IA 50310
Phone (515) 278-0949
1301 Penn Ave
Ste 406
Des Moines, IA 50316
Phone (515) 263-2412
1200 Pleasant St
Ste S228
Des Moines, IA 50309
1212 Pleasant St
Ste 116
Des Moines, IA 50309
1200 Pleasant St
Ste 303
Des Moines, IA 50309
1200 Pleasant St
Ste 228
Des Moines, IA 50309
1200 Pleasant St
#P
Des Moines, IA 50309
1212 Pleasant St
Ste 410
Des Moines, IA 50309
101 SE Destination Dr
Grimes, IA 50111
Phone (515) 986-4524
1002 W Lincoln Way
Jefferson, IA 50129
Phone (515) 386-0500
800 S Fillmore St
Osceola, IA 50213
Phone (641) 342-2184
2901 86th St
Urbandale, IA 50322
Phone (515) 276-3406
6600 Westown Pkwy
Ste 220
West Des Moines, IA 50266
Phone (515) 241-2250
6000 University Ave
Ste 200
West Des Moines, IA 50266
Phone (515) 241-2300
6010 Mills Civic Pkwy
Ste 200
West Des Moines, IA 50266
Phone (515) 224-9666
4055 Westown Pkwy
West Des Moines, IA 50266
Phone (515) 224-3399
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | |||
| Family Medicine Physician |
207Q00000X | Yes | ||
| Obstetrics & Gynecology Physician |
207V00000X | |||
| Radiation Oncology Physician |
2085R0001X | |||
| Family Nurse Practitioner |
363LF0000X |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0096958 | Medicaid | IA | |
| CC7397 | Other | IA | RAILROAD MEDICARE GROUP |
Other names
- East Des Moines Family Care Center
Other providers in Des Moines, IA
- Central Iowa Hospital Corp.
- Central Iowa Hospital Corporation
- Central Iowa Hospital Corporation
- Central Iowa Hospital Corporation
- Central Iowa Hospital Corporation
- Central Iowa Hospital Corporation
- Central Iowa Hospital Corporation
- Central Iowa Hospital Corporation
- Central Iowa Hospital Corporation
- Central Iowa Hospital Corporation
All providers in Des Moines, IA · Family Medicine Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.