Individual provider Active NPI

Ciarra Alexandria Lang

  • Pediatric Nurse Practitioner
  • Cedar Rapids, IA
National Provider Identifier
1366828121
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
C129126 Issued in IA
Practice address
855 A Ave NE
Suite 300
Cedar Rapids, IA 52402-5057
Phone
(319) 368-9301
NPI assigned
Aug 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X C129126 IA Primary

Addresses

Primary practice location

855 A Ave NE
Suite 300
Cedar Rapids, IA 52402-5057

Mailing address

855 A Ave NE
Suite 300
Cedar Rapids, IA 52402-5057

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150814014197 IA Practitioner - Nurse Practitioner 8224343595 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
C129126IAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Methodist Hospital Current Accepting new patients
Iowa Physicians Clinic Medical Foundation CurrentSince Aug 10, 2015 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

855 A Ave NE
Ste 300
Cedar Rapids, IA 52402
Phone (319) 368-9300

8101 Birchwood Ct
Unit R
Urbandale, IA 50131
Phone (515) 471-9363

Interoperability endpoints

  • Direct secure messaging: clang269605@direct.unitypoint.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1366828121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 A AVE NE",
            "address_2": "SUITE 300",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524025057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 A AVE NE",
            "address_2": "SUITE 300",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524025057",
            "telephone_number": "319-368-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANG",
        "first_name": "CIARRA",
        "middle_name": "ALEXANDRIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-04",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IA",
            "license": "C129126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.