Iowa Plastic Surgery Center LC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

29526 Issued in IA

Legal business name

IOWA PLASTIC SURGERY CENTER LC

Practice address

4334 E 53Rd St
Davenport, IA 52807-3039

Phone

(563) 322-8877

Fax

(563) 322-8375

NPI assigned

Jan 10, 2006

Last updated

Feb 15, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Benjamin Adam Vanraalte, M.D.NPI 1528048451

Title

Owner

Phone

(563) 322-8877

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Benjamin Vanraalte, M.D.

  • Specialist
  • Davenport, IA
  • NPI 1528048451
  Authorized official Same address or phone

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266192000000",
    "number": "1215916184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4334 E 53RD ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073039",
            "telephone_number": "563-322-8877",
            "fax_number": "563-322-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4334 E 53RD ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073039",
            "telephone_number": "563-322-8877",
            "fax_number": "563-322-8375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA PLASTIC SURGERY CENTER LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-10",
        "last_updated": "2010-02-15",
        "status": "A",
        "authorized_official_last_name": "VANRAALTE",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "563-322-8877",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IA",
            "license": "29526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "IA0113241",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Iowa Hearing Associates LLC (Miracle Ear)
• Iowa Illinois Pain Consultants
• Iowa Illinois Pain Consultants P.C.
• Iowa Physicians Clinic Medical Foundation (Iowa Health Physicians)
• Iowa Physicians Eyecare Group, P.C.
• Iowa Plastic Surgery, PC
• Ashlynn Ireland
• Penny Marie Irish, LMT
• Laura Irwin
• Virgie Lavette Islas, OTR/L

• Ambulatory Surgical Clinic/Center in Davenport, IA
• Providers in Davenport, IA by specialty
• Ambulatory Surgical Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2010; 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.