Individual provider Active NPI

Elizabeth A Foutch, PA

  • Physician Assistant
  • Johnston, IA
National Provider Identifier
1194519256
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
134509 Issued in IA
Practice address
5705 NW 100TH St Ste 100
Johnston, IA 50131-1813
Phone
(515) 726-3376
Fax
(515) 446-9707
NPI assigned
Apr 5, 2025
Last updated
Sep 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 134509 IA Primary

Addresses

Primary practice location

5705 NW 100TH St Ste 100
Johnston, IA 50131-1813

Mailing address

8405 Blackstone
Johnston, IA 50131-8738
Phone (515) 971-4184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251120002016 IA Practitioner - Physician Assistant 7618469313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Iowa Dermatology LLCGroup PAC ID 3173859378, 5 clinicians

Practice addresses (Care Compare)

2720 8TH St SW
Unity Point Clinic
Altoona, IA 50009-1028
Phone (515) 726-3376

5705 NW 100TH St
Suite 100
Johnston, IA 50131-1813
Phone (515) 726-3376

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
134509IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Central Iowa Dermatology LLC CurrentSince Sep 9, 2025 Accepting new patients

Locations

2720 8th St SW
Altoona, IA 50009
Phone (515) 957-8609

5705 NW 100th St
Ste 100
Johnston, IA 50131

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1743811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1194519256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8405 BLACKSTONE",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501318738",
            "telephone_number": "515-971-4184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5705 NW 100TH ST STE 100",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501311813",
            "telephone_number": "515-726-3376",
            "fax_number": "515-446-9707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUTCH",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-05",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "134509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnston, IA

Sources for this page

Verify at the official NPI Registry.