NPIMap

Organization Active NPI

Iowa Physicians Clinic Medical Foundation

  • Family Medicine Physician
  • Geneseo, IL
National Provider Identifier
1285005850
Registry record updated Dec 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION
Practice address
600 N College Ave
Suite 120
Geneseo, IL 61254-1095
Phone
(309) 944-5342
Fax
(309) 945-4079
NPI assigned
Oct 8, 2015
Last updated
Dec 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2015

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

Authorized official

Name
Erick J Laine
Title
VP/Coo
Phone
(515) 471-9227

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X IL
Nurse Practitioner 363L00000X IL
Family Medicine Physician 207Q00000X IL Primary

Addresses

Primary practice location

600 N College Ave
Suite 120
Geneseo, IL 61254-1095

Mailing address

600 N College Ave
Suite 120
Geneseo, IL 61254-1095
Phone (309) 944-5342

National Provider Directory

National Provider Directory
Tax ID family
Intergra Health21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1444262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450310400000",
    "number": "1285005850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N COLLEGE AVE",
            "address_2": "SUITE 120",
            "city": "GENESEO",
            "state": "IL",
            "postal_code": "612541095",
            "telephone_number": "309-944-5342",
            "fax_number": "309-945-4079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N COLLEGE AVE",
            "address_2": "SUITE 120",
            "city": "GENESEO",
            "state": "IL",
            "postal_code": "612541095",
            "telephone_number": "309-944-5342",
            "fax_number": "309-945-4079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-08",
        "last_updated": "2015-12-17",
        "status": "A",
        "authorized_official_last_name": "LAINE",
        "authorized_official_first_name": "ERICK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VP/COO",
        "authorized_official_telephone_number": "515-471-9227"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneseo, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2015; 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.