NPIMap

Organization Active NPI

Broadlawns Medical Center

  • Eyewear Supplier
  • Des Moines, IA
National Provider Identifier
1235541434
Registry record updated May 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
770032H Issued in IA
Legal business name
BROADLAWNS MEDICAL CENTER
Practice address
1801 Hickman Rd
Des Moines, IA 50314-1505
Phone
(515) 282-2296
Fax
(515) 282-7856
NPI assigned
May 22, 2014
Last updated
May 22, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2014

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

Authorized official

Name
Mr. Karl Vilums
Title
Chief Financial Officer
Phone
(515) 282-2296

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 770032H IA Primary

Addresses

Primary practice location

1801 Hickman Rd
Des Moines, IA 50314-1505

Mailing address

1801 Hickman Rd
Des Moines, IA 50314-1505
Phone (515) 282-2296

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181023003225 IA DME Supplier - Optician 3678466166 Practice locations: Des Moines, 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
Anesthesiology Service16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Broadlawns Medical CenterDes Moines, IA, CCN 160101 Hospital Operational/Managerial Control Nov 16, 2007

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1400716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400716800000",
    "number": "1235541434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 HICKMAN RD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503141505",
            "telephone_number": "515-282-2296",
            "fax_number": "515-282-7856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 HICKMAN RD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503141505",
            "telephone_number": "515-282-2296",
            "fax_number": "515-282-7856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADLAWNS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-22",
        "last_updated": "2014-05-22",
        "status": "A",
        "authorized_official_last_name": "VILUMS",
        "authorized_official_first_name": "KARL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "515-282-2296",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "IA",
            "license": "770032H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.