NPIMap

Organization Active NPI

Physicians' Clinic of Iowa, PC

  • Durable Medical Equipment & Medical Supplies
  • Cedar Rapids, IA
National Provider Identifier
1124157276
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PHYSICIANS' CLINIC OF IOWA, PC
Practice address
202 10TH St SE Ste 290
Cedar Rapids, IA 52403-2437
Phone
(319) 398-1500
Fax
(319) 398-1558
NPI assigned
Mar 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Authorized official

Name
Eric Dalton
Title
Cfo
Phone
(319) 247-3049

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

202 10TH St SE Ste 290
Cedar Rapids, IA 52403-2437

Mailing address

PO Box 3178
Cedar Rapids, IA 52406-3178
Phone (319) 398-1500

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://fhirstagingsrv.eclinicalweb.com/FHIRServer/fhir/JIJCBD/metadata Direct
FHIR URL https://fhirstagingsrv.eclinicalweb.com/FHIRServer/fhir/JIJCBD/metadata Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930040467 IA DME Supplier - Physician - Orthopedic/Orthopedic Surgery 2163325242 Practice locations: Cedar Rapids, IA

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
James E Spoden MD Facs12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

275 10th St SE
Cedar Rapids, IA 52403
Phone (319) 247-3668

Practitioners & affiliated clinicians

Practitioners 132

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

View all 132

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603152000000",
    "number": "1124157276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3178",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524063178",
            "telephone_number": "319-398-1500",
            "fax_number": "319-398-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 10TH ST SE STE 290",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524032437",
            "telephone_number": "319-398-1500",
            "fax_number": "319-398-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS' CLINIC OF IOWA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-09",
        "status": "A",
        "authorized_official_last_name": "DALTON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "319-247-3049"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhirstagingsrv.eclinicalweb.com/FHIRServer/fhir/JIJCBD/metadata",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "202 10th St SE",
            "city": "Cedar Rapids",
            "state": "IA",
            "country_code": "US",
            "postal_code": "524032414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhirstagingsrv.eclinicalweb.com/FHIRServer/fhir/JIJCBD/metadata",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "275 10th St SE",
            "city": "Cedar Rapids",
            "state": "IA",
            "country_code": "US",
            "postal_code": "524032450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.