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Central Iowa Hospital Corporation

Organization Active NPI Internal Medicine Physician · Des Moines, IA

NPI 1194776955 · NPPES record last updated May 21, 2008

Key facts

NPI
1194776955
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
CENTRAL IOWA HOSPITAL CORPORATION
Practice address
1201 Pennsylvania Ave
Des Moines, IA 50316-2339
Phone
(515) 266-1000
Fax
(515) 266-1824
NPI assigned
May 15, 2006
Organization subpart
Yes
Parent organization (as reported)
CENTRAL IOWA HOSPITAL CORPORATION

Authorized official

Name
Mr. Joseph F. Corfits Jr.
Title
Cfo
Phone
(515) 241-6507

Other NPIs on the same Medicare enrollment 20

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IA

Medicare enrollment records

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
This NPI is an additional NPI on the enrollment

National Provider Directory

Part of
Methodist Hospital

Locations

1201 Pennsylvania Ave
Des Moines, IA 50316
Phone (515) 266-1000

1200 Pleasant St
Des Moines, IA 50309
Phone (515) 241-5926

1215 Pleasant St
Ste 506
Des Moines, IA 50309
Phone (515) 214-4044

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207R00000X Yes

Addresses

Primary practice location

1201 Pennsylvania Ave
Des Moines, IA 50316-2339

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
CI3009OtherIARAILROAD MEDICARE GROUP
0227926MedicaidIA

Other names

  • Penn Avenue Internal Medicine Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 21, 2008.

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1194776955",
    "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": "1201 PENNSYLVANIA AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503162339",
            "telephone_number": "515-266-1000",
            "fax_number": "515-266-1824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL IOWA HOSPITAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRAL IOWA HOSPITAL CORPORATION",
        "enumeration_date": "2006-05-15",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "CORFITS",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "515-241-6507",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "CI3009",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0227926",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Penn Avenue Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Des Moines, IA

All providers in Des Moines, IA · Internal Medicine Physician in Iowa

Sources for this page

Verify at the official NPI Registry.