NPIMap

Organization Active NPI

Physicians' Clinic of Iowa, PC, Dept of Surgical Specialists

  • Surgery Physician
  • Cedar Rapids, IA
National Provider Identifier
1437209137
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
PHYSICIANS' CLINIC OF IOWA, PC, DEPT OF SURGICAL SPECIALISTS
Practice address
830 4TH Ave SE
Cedar Rapids, IA 52403-2423
Phone
(319) 362-5118
Fax
(319) 364-0574
NPI assigned
Jan 12, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Donna S Cooper
Title
Ceo
Phone
(319) 398-1772

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

830 4TH Ave SE
Cedar Rapids, IA 52403-2423

Mailing address

830 4TH Ave SE
Cedar Rapids, IA 52403-2423
Phone (319) 362-5118

Other identifiers 1

IdentifierTypeStateIssuer
56498OtherIAWELLMARK GROUP NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Physicians' Clinic of Iowa PC Dept of Urology12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

830 4th Ave SE
Cedar Rapids, IA 52403
Phone (319) 362-5118

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437209137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 4TH AVE SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524032423",
            "telephone_number": "319-362-5118",
            "fax_number": "319-364-0574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 4TH AVE SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524032423",
            "telephone_number": "319-362-5118",
            "fax_number": "319-364-0574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS' CLINIC OF IOWA, PC, DEPT OF SURGICAL SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "319-398-1772"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK GROUP NUMBER",
            "identifier": "56498",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.