Individual provider Active NPI

Julie L Anderson-Suddarth, MD

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Des Moines, IA
National Provider Identifier
1245214436
Registry record updated Aug 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
33838 Issued in IA
Practice address
1200 Pleasant St
Pediatric Emergency Department
Des Moines, IA 50309-1406
Phone
(515) 241-5926
Fax
(515) 241-5127
NPI assigned
Dec 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 33838 IA Primary

Addresses

Primary practice location

1200 Pleasant St
Pediatric Emergency Department
Des Moines, IA 50309-1406

Mailing address

1200 Pleasant St
Pediatric Emergency Department
Des Moines, IA 50309-1406
Phone (515) 241-5926

Other identifiers 2

IdentifierTypeStateIssuer
0470849MedicaidIA
I16623OtherMEDICARE

Other names 1

  • Julie L Anderson Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051215000094 IA Practitioner - Pediatric Medicine 7416978655 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33838IAMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Central Iowa Hospital Corporation Pediatric Emergency Medicine CurrentSince Oct 4, 2010 Accepting new patients
Central Iowa Hospital Corporation CurrentSince Oct 4, 2010 Accepting new patients
Central Iowa Hospital Corporation Current Accepting new patients

Locations

1200 Pleasant St
Rm 236
Des Moines, IA 50309
Phone (515) 241-6228

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

Interoperability endpoints

  • Direct secure messaging: jandersonsuddarth12143@direct.unitypoint.org

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251244800000",
    "number": "1245214436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 PLEASANT ST",
            "address_2": "PEDIATRIC EMERGENCY DEPARTMENT",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091406",
            "telephone_number": "515-241-5926",
            "fax_number": "515-241-5127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 PLEASANT ST",
            "address_2": "PEDIATRIC EMERGENCY DEPARTMENT",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091406",
            "telephone_number": "515-241-5926",
            "fax_number": "515-241-5127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON-SUDDARTH",
        "first_name": "JULIE",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-01",
        "last_updated": "2009-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "IA",
            "license": "33838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0470849",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "I16623",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "ANDERSON",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.