NPIMap

Organization Active NPI

Iowa Physicians Clinic Medical Foundation

  • Durable Medical Equipment & Medical Supplies
  • Ottumwa, IA
National Provider Identifier
1245269646
Registry record updated Sep 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION
Doing business as
Ottumwa Family Practice & Specialty
Practice address
623 Pennsylvania Ave
Ottumwa, IA 52501-2116
Phone
(641) 682-7571
Fax
(641) 682-6550
NPI assigned
Jun 30, 2006
Organization subpart
Yes
Parent organization
IOWA PHYSICIANS CLINIC MEDICAL FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 4, 2012

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

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

623 Pennsylvania Ave
Ottumwa, IA 52501-2116

Mailing address

8101 Birchwood Court
Suite R
Johnston, IA 50131-2930
Phone (515) 471-9243

Other names 1

  • Ottumwa Family Practice & Specialty Doing business as

National Provider Directory

National Provider Directory
Part of
Jeffrey Carandall MD

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346716800000",
    "number": "1245269646",
    "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": "623 PENNSYLVANIA AVE",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525012116",
            "telephone_number": "641-682-7571",
            "fax_number": "641-682-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION",
        "enumeration_date": "2006-06-30",
        "last_updated": "2012-09-04",
        "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": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ottumwa Family Practice & Specialty",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ottumwa, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.