Family Physicians of Cedar Rapids, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FAMILY PHYSICIANS OF CEDAR RAPIDS, P.C.

Practice address

1515 42ND St NE
Cedar Rapids, IA 52402-3061

Phone

(319) 365-7581

Fax

(319) 365-0163

NPI assigned

Jul 3, 2006

Last updated

Jun 23, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark J Goedken, MDNPI 1386630663

Title

President

Phone

(319) 365-7581

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Family Physcnscedar Rapids2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Family Physicians of Cedar Rapids, P.C.

  • Family Medicine Physician
  • Cedar Rapids, IA
  • NPI 1609108711
  NPD tax ID

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark J Goedken, MD

  • Family Medicine Physician
  • Cedar Rapids, IA
  • NPI 1386630663
  Medicare reassignment Authorized official
• Jennifer Lynn Forkner, ARNP

  • Nurse Practitioner
  • Cedar Rapids, IA
  • NPI 1710282355
  Medicare reassignment
• Bradley Beer, MD

  • Family Medicine Physician
  • Hiawatha, IA
  • NPI 1497715676
  NPD (past)
• Amanda Jean Gerber, MD

  • Family Medicine Physician
  • Bonaparte, IA
  • NPI 1396909701
  NPD (past)
• Richard Darrell Louvar, D.O.

  • Family Medicine Physician
  • Cedar Rapids, IA
  • NPI 1871579532
  NPD (past)
• Mindy Teann Martin, ARNP

  • Adult Health Nurse Practitioner
  • Cedar Rapids, IA
  • NPI 1871543108
  NPD (past)
• Tracy L Niemeyer, MD

  • Family Medicine Physician
  • Cedar Rapids, IA
  • NPI 1275512113
  NPD (past)

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655942400000",
    "number": "1285663849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 42ND ST NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524023061",
            "telephone_number": "319-365-7581",
            "fax_number": "319-365-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 42ND ST NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524023061",
            "telephone_number": "319-365-7581",
            "fax_number": "319-365-0163"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "811 5th Ave SE",
            "address_purpose": "LOCATION",
            "city": "Cedar Rapids",
            "state": "IA",
            "postal_code": "524032421",
            "country_code": "US",
            "telephone_number": "319-365-7581",
            "fax_number": "319-365-0163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FAMILY PHYSICIANS OF CEDAR RAPIDS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A",
        "authorized_official_last_name": "GOEDKEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "319-365-7581",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINIC NUMBER",
            "identifier": "15468",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0154682",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Family Chiropractic Wellness Center, Inc.
• Family Dental Care Associates PLC
• Family Foot Care Center, PLC
• Family Foot Care Clinic, PC
• Family Medicine Specialists, P.C.
• Family Physicians of Cedar Rapids, P.C.
• Family Practice Center
• Family Psychology Associates, P.C.
• Family Smilecare Center
• Ashlee Erin Fandel, P.T.

• Family Medicine Physician in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.