Active NPI
Thomas O Paulson, MD
- Otolaryngology Physician
- West Des Moines, IA
National Provider Identifier
1407814346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 26559
- Practice address
- 105 Valley West Dr
Suite 100
West Des Moines, IA 50265-3902 - Phone
- (515) 223-4368
- Fax
- (515) 453-2368
- NPI assigned
- May 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 26559 | IA | Primary |
Addresses
Primary practice location
105 Valley West Dr
Suite 100
West Des Moines, IA 50265-3902
Mailing address
105 Valley West Dr
Suite 100
West Des Moines, IA 50265-3902
Phone (515) 223-4368
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4261149 | Medicaid | IA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 26559 | IA | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430956800000",
"number": "1407814346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 VALLEY WEST DR",
"address_2": "SUITE 100",
"city": "WEST DES MOINES",
"state": "IA",
"postal_code": "502653902",
"telephone_number": "515-223-4368",
"fax_number": "515-453-2368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 VALLEY WEST DR",
"address_2": "SUITE 100",
"city": "WEST DES MOINES",
"state": "IA",
"postal_code": "502653902",
"telephone_number": "515-223-4368",
"fax_number": "515-453-2368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAULSON",
"first_name": "THOMAS",
"middle_name": "O",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-02",
"last_updated": "2015-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "IA",
"license": "26559",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4261149",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.