Karla Kay Cheney, MD
Individual provider Active NPI Pediatrics Physician · Carroll, IA
NPI 1407968704 · NPPES record last updated Jun 4, 2013
Key facts
- NPI
- 1407968704
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 28885 (IA)
- Practice address
- 405 S Clark St
Suite 100
Carroll, IA 51401-3065 - Phone
- (712) 792-2222
- Fax
- (712) 792-3875
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28885 | IA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boone County Hospital | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 28885 | IA | Yes |
Addresses
Primary practice location
405 S Clark St
Suite 100
Carroll, IA 51401-3065
Mailing address
1929 Lois Avenue
Carroll, IA 51401
Phone (712) 792-8152
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35947 | Other | NE | WELLMARK |
| 42146645100 | Medicaid | NE |
Other providers in Carroll, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.