NPIMap

Organization Active NPI

Jerrold V. Flatt D.O., P.C.

  • Family Medicine Physician
  • Des Moines, IA
National Provider Identifier
1396771622
Registry record updated Nov 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01819 Issued in IA
Legal business name
JERROLD V. FLATT D.O., P.C.
Practice address
1301 Pennsylvania Ave Ste 316
Des Moines, IA 50316-2366
Phone
(515) 262-0996
Fax
(515) 264-1009
NPI assigned
Jun 26, 2006
Last updated
Nov 23, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2009

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

Authorized official

Name
Dr. Jerrold Verlin Flatt, D.O.NPI 1073594768
Title
Physician/Owner
Phone
(515) 262-0996

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01819 IA Primary

Addresses

Primary practice location

1301 Pennsylvania Ave Ste 316
Des Moines, IA 50316-2366

Mailing address

1301 Penn Ave Ste 316
Des Moines, IA 50316-2366
Phone (515) 262-0996

Other identifiers 1

IdentifierTypeStateIssuer
0710803MedicaidIA

National Provider Directory

National Provider Directory

Locations

1301 Pennsylvania Ave
Ste 316
Des Moines, IA 50316
Phone (515) 262-0996

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258934400000",
    "number": "1396771622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 PENN AVE STE 316",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503162366",
            "telephone_number": "515-262-0996",
            "fax_number": "515-264-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PENNSYLVANIA AVE STE 316",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503162366",
            "telephone_number": "515-262-0996",
            "fax_number": "515-264-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERROLD V. FLATT D.O., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2009-11-23",
        "status": "A",
        "authorized_official_last_name": "FLATT",
        "authorized_official_first_name": "JERROLD",
        "authorized_official_middle_name": "VERLIN",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "515-262-0996",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "01819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0710803",
            "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 Nov 23, 2009; 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.