Individual provider Active NPI

Jerusa Kamala, MD

  • Specialist
  • Des Moines, IA
National Provider Identifier
1285601641
Registry record updated Feb 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
34967 Issued in IA
Practice address
1250 9TH Street
Des Moines, IA 50316-2765
Phone
(515) 263-2600
Fax
(515) 263-2620
NPI assigned
Mar 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 34967 IA Primary

Addresses

Primary practice location

1250 9TH Street
Des Moines, IA 50316-2765

Mailing address

1250 E 9TH St
Des Moines, IA 50316-2316
Phone (515) 263-2600

Other identifiers 2

IdentifierTypeStateIssuer
0284695MedicaidIA
1285601641MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34967IAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423526400000",
    "number": "1285601641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 E 9TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503162316",
            "telephone_number": "515-263-2600",
            "fax_number": "515-263-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 9TH STREET",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503162765",
            "telephone_number": "515-263-2600",
            "fax_number": "515-263-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMALA",
        "first_name": "JERUSA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-03",
        "last_updated": "2015-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IA",
            "license": "34967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0284695",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285601641",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.