Individual provider Active NPI

Tami Rae Fahnlander, D.O.

  • Obstetrics & Gynecology Physician
  • Clive, IA
National Provider Identifier
1275743395
Registry record updated Oct 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
3778 Issued in IA
Practice address
12339 Stratford Dr
Clive, IA 50325-8148
Phone
(515) 263-8569
NPI assigned
May 24, 2007
Last updated
Oct 15, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 125-047470 IL
Obstetrics & Gynecology Physician 207V00000X 3778 IA Primary

Addresses

Primary practice location

12339 Stratford Dr
Clive, IA 50325-8148

Mailing address

12339 Stratford Dr
Clive, IA 50325-8148
Phone (515) 263-8569

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
I20080821000387 IA Practitioner - Obstetrics/Gynecology 4688749906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 Pleasant St
Des Moines, IA 50309-1406
Phone (515) 241-6212

12339 Stratford Dr
Clive, IA 50325-8148
Phone (515) 263-9107

1660 60TH St
West Des Moines, IA 50266-7700
Phone (515) 343-1000

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3778IAMDObstetrics & Gynecology Physician
125-047470ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Iowa Physicians Clinic Medical Foundation Obstetrics & Gynecology CurrentSince Oct 9, 2017 Accepting new patients
Mercy Clinics, Inc. Obstetrics & Gynecology Past Accepting new patients
Central Iowa Hospital Corporation Past Accepting new patients
Trinity Medical Center Past 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

12339 Stratford Dr
Clive, IA 50325
Phone (515) 263-9107

1660 60th St
#M
West Des Moines, IA 50266
Phone (515) 343-1000

1776 Westlakes Pkwy
Ste 400
West Des Moines, IA 50266
Phone (515) 241-6161

Interoperability endpoints

  • Direct secure messaging: tfahnlander9585@direct.unitypoint.org

Organizations & group practices 6

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350259200000",
    "number": "1275743395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12339 STRATFORD DR",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258148",
            "telephone_number": "515-263-8569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12339 STRATFORD DR",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258148",
            "telephone_number": "515-263-8569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHNLANDER",
        "first_name": "TAMI",
        "middle_name": "RAE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2012-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "125-047470",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IA",
            "license": "3778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

Verify at the official NPI Registry.