Iowa Physicians Clinic Medical Foundation

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION

Doing business as

Clarence Family Medicine

Practice address

411 1St Ave
Clarence, IA 52216-9744

Phone

(563) 452-3211

Fax

(563) 452-3215

NPI assigned

Jun 18, 2006

Last updated

Aug 15, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

IOWA PHYSICIANS CLINIC MEDICAL FOUNDATIONAs reported in NPPES

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

Authorized official

Name

Erick J Laine

Title

Coo

Phone

(515) 471-9227

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Clarence Family Medicine Doing business as

Part of

Intergra Health

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344988800000",
    "number": "1194760561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 BIRCHWOOD COURT",
            "address_2": "SUITE R",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312930",
            "telephone_number": "515-471-9243",
            "fax_number": "515-471-9319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 1ST AVE",
            "city": "CLARENCE",
            "state": "IA",
            "postal_code": "522169744",
            "telephone_number": "563-452-3211",
            "fax_number": "563-452-3215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION",
        "enumeration_date": "2006-06-18",
        "last_updated": "2012-08-15",
        "status": "A",
        "authorized_official_last_name": "LAINE",
        "authorized_official_first_name": "ERICK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "515-471-9227"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0638981",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarence Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• City of Clarence
• Clarence Nursing Home Inc (Clarence Nursing Home)
• Clarence Nursing Home, Inc
• Frederick Russell Drexler, DDS
• Heal With Cat
• Sara J Otten, PT
• Anna C. Pruess, A.R.N.P.
• Heather Lynn Schott, ARNP
• Cat St Clair
• St Luke's Jones Regional Medical Center (Unitypoint Health-Family Medicine Clinic-Clarence)

• Rural Health Clinic/Center in Clarence, IA
• Providers in Clarence, IA by specialty
• Rural Health Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.