Individual provider Active NPI

Karen M Kemp-Glock, DO

  • Obstetrics & Gynecology Physician
  • Clive, IA
National Provider Identifier
1285638734
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
3249 Issued in IA
Practice address
12339 Stratford Dr
Clive, IA 50325-8148
Phone
(515) 263-9107
Fax
(515) 265-9888
NPI assigned
Jun 10, 2005
Last updated
Oct 31, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 3249 IA Primary

Addresses

Primary practice location

12339 Stratford Dr
Clive, IA 50325-8148

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
09743OtherIAWELLMARK, ANKENY OFFICE
0192682MedicaidIA
06751OtherIAWELLMARK BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, AR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120201000792 IA Practitioner - Obstetrics/Gynecology 4082507967 Reassigns benefits to 1 organization
I20200925000768 AR Practitioner - Obstetrics/Gynecology 4082507967 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinics IncGroup PAC ID 7911810882, 441 clinicians

Practice addresses (Care Compare)

1601 NW 114TH St
Clive, IA 50325-7036

1601 NW 114TH St
Clive, IA 50325-7046

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3249IAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinics, Inc Obstetrics & Gynecology CurrentSince Jan 17, 2017 Accepting new patients
Mercy Clinics, Inc. Current Accepting new patients
Mercy Clinics, Inc. Obstetrics & Gynecology CurrentSince Jan 17, 2017 Accepting new patients
Obhg Arkansas West PA Obstetrics & Gynecology CurrentSince Sep 22, 2020 Accepting new patients
Union Hospital Inc. Current Accepting new patients
Obhg Arkansas, PA Obstetrics & Gynecology CurrentSince Jan 1, 2021 Accepting new patients
Mercy Clinics, Inc. Past Accepting new patients
Mercy Women's Health Services Obstetrics & Gynecology Past Accepting new patients

Locations

7301 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-4600

1111 6th Ave
Des Moines, IA 50314
Phone (515) 247-3121

1601 NW 114th St
Ste 151
Des Moines, IA 50325
Phone (515) 222-7474

1601 NW 114th St
Ste 247
Des Moines, IA 50325
Phone (515) 222-7000

330 Laurel St
Ste 1200
Des Moines, IA 50314
Phone (515) 643-5454

405 SW 5th St
Ste E
Des Moines, IA 50309
Phone (515) 358-7259

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

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

777 Lowndes Hill Rd
Bldg 1
Greenville, SC 29607

Interoperability endpoints

  • Direct secure messaging: kglock@unionhealth.cernerdirect.com
  • Direct secure messaging: kkempglock3949093@direct.trinity-health.org

Organizations & group practices 8

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 4

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": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193788800000",
    "number": "1285638734",
    "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": "515-263-9107",
            "fax_number": "515-265-9888"
        },
        {
            "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": "515-263-9107",
            "fax_number": "515-265-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMP-GLOCK",
        "first_name": "KAREN",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-10",
        "last_updated": "2007-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IA",
            "license": "3249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK, ANKENY OFFICE",
            "identifier": "09743",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0192682",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BLUE SHIELD",
            "identifier": "06751",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

Verify at the official NPI Registry.