Individual provider Active NPI

Kaitlin Dammann, PA-C

  • Physician Assistant
  • Des Moines, IA
National Provider Identifier
1265955421
Registry record updated Jul 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
088163 Issued in IA
Practice address
2103 Ingersoll Ave
Des Moines, IA 50312-5227
Phone
(515) 279-6242
NPI assigned
Jul 19, 2017
Last updated
Jul 19, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 088163 IA Primary

Addresses

Primary practice location

2103 Ingersoll Ave
Des Moines, IA 50312-5227

Mailing address

9224 Kingman Dr
West Des Moines, IA 50266-1511
Phone (515) 480-1625

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170815001612 IA Practitioner - Physician Assistant 9931471703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2515 Grand Prairie Pkwy
Waukee, IA 50263-8966
Phone (515) 644-9000

30 E Hickman Rd
Family Med Waukee
Waukee, IA 50263-5011
Phone (515) 987-3447

40 E Hickman Rd
Pediatrics Waukee
Waukee, IA 50263-5011
Phone (515) 987-6610

4480 Utica Ridge Rd
Bettendorf, IA 52722-1644

50 E Hickman Rd
PT Waukee
Waukee, IA 50263-5011
Phone (515) 216-2999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
088163IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Iowa Physicians Clinic Medical Foundation CurrentSince Oct 1, 2017 Accepting new patients
Iowa Physicians Clinic Medical Foundation Physician Assistant CurrentSince Oct 1, 2017 Accepting new patients
Central Iowa Hospital Corporation Past Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

Interoperability endpoints

  • Direct secure messaging: kdammann532932@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500422400000",
    "number": "1265955421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9224 KINGMAN DR",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661511",
            "telephone_number": "515-480-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 INGERSOLL AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503125227",
            "telephone_number": "515-279-6242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMMANN",
        "first_name": "KAITLIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-19",
        "last_updated": "2017-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "088163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.