Active NPI
State University of Iowa
- Family Medicine Physician
- Iowa City, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- STATE UNIVERSITY OF IOWA
- Practice address
- 200 Hawkins Dr
Iowa City, IA 52242 - Phone
- (319) 356-1616
- Fax
- (319) 384-5164
- NPI assigned
- Aug 9, 2005
- Organization subpart
- Yes
- Parent organization
- STATE UNIVERSITY OF IOWA
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Douglas J Vandaele, MD
- Title
- Associate Dean
- Phone
- (319) 353-8162
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | IA | Primary | |
| Internal Medicine Physician | 207R00000X | IA | ||
| Pediatrics Physician | 208000000X | IA | ||
| Surgery Physician | 208600000X | IA |
Addresses
Primary practice location
200 Hawkins Dr
Iowa City, IA 52242
Mailing address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-1616
Other practice location 1
920 E 2nd Ave Ste 201A&b
Coralville, IA 52241-2219
Phone (319) 467-2000
Other practice location 2
105 E 9th St
Coralville, IA 52241-2209
Phone (319) 467-2000
Other practice location 3
2701 Prairie Meadow Dr
Iowa City, IA 52242-8001
Phone (319) 384-7070
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33537 | Other | IA | WELLMARK BCBS OF IA |
| 004246 | Medicaid | IA |
Other names 2
- University of Iowa Health Care
- University of Iowa Hospitals & Clinics/Medical Service Plan
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA, IL, SD, WA, CA, PA, VA, TX, FL, WI, NJ, SC, MA, TN, AL, CT, NY, CO, MO, MI, MD, OR, AZ, UT, NE, DC, GA, MS, NC, NM, NH, KY
Enrollment records 32
Other NPIs with the same Medicare PAC ID 20
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Washington, IA
- NPI 1093790578
7618884230
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- North Liberty, IA
- NPI 1629054846
7618884230
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Iowa City, IA
- NPI 1639157415
7618884230
Other NPIs on the same Medicare enrollment 36
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Washington, IA
- NPI 1093790578
O20031107000060
-
- Plastic and Reconstructive Surgery Physician
- Cedar Rapids, IA
- NPI 1114390358
O20031107000060
National Provider Directory
National Provider Directory- Part of
- Louis V Kirchoff MD
Locations (25 of 95)
2181 Kalakaua Ave
Honolulu, HI 96815
Phone (213) 309-8948
1950 SW Magazine Rd
#U
Ankeny, IA 50023
Phone (515) 237-7066
2220 S Ankeny Blvd
Ankeny, IA 50023
Phone (515) 725-1600
1905 SW Magazine Rd
Ankeny, IA 50023
1950 SW Magazine Rd
Ankeny, IA 50023
204 W 7th St
#U
Carroll, IA 51401
Phone (712) 792-5530
501 13th St NW
Cedar Rapids, IA 52405
Phone (319) 892-5612
411 10th St SE
Ste 150
Cedar Rapids, IA 52403
Phone (319) 363-3600
1231 Park Pl NE
#U
Cedar Rapids, IA 52402
Phone (319) 363-3600
1224 13th St NW
Cedar Rapids, IA 52405
Phone (319) 365-9171
1 Saint Joseph Dr
#U
Centerville, IA 52544
Phone (641) 437-3482
1663 Lincoln Way
Ste De
Clinton, IA 52732
Phone (563) 243-0292
1663A Lincoln Way
Ste De
Clinton, IA 52732
Phone (563) 243-0292
240 N Bluff Blvd
Ste 200
Clinton, IA 52732
Phone (563) 243-0100
1663A Lincoln Way
#U
Clinton, IA 52732
Phone (563) 243-0292
2769 Heartland Dr
Ste 203
Coralville, IA 52241
Phone (319) 688-7517
2510 Corridor Way
Ste 6A
Coralville, IA 52241
Phone (319) 334-8500
2450 Coral Ct
#U
Coralville, IA 52241
Phone (319) 645-3300
2055 Oakdale Rd
#U
Coralville, IA 52241
Phone (319) 248-0037
2510 Corridor Way
Coralville, IA 52241
2055 Oakdale Rd
Coralville, IA 52241
Phone (319) 248-0037
105 E 9th St
Ste A
Coralville, IA 52241
Phone (319) 467-2050
920 E 2nd Ave
Ste 201B
Coralville, IA 52241
Phone (319) 467-2000
3281 Ridgeway Dr
Ste 213
Coralville, IA 52241
Phone (319) 358-2740
920 E 2nd Ave
Ste 201
Coralville, IA 52241
Phone (319) 384-7000
Ownership & related parties
All facility ownership & control disclosures 4
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| University of Iowa Health Care Medical Center | Hospital | Other | Jul 1, 1966 |
| University of Iowa Health Care Medical Center | Hospital | Other | Jul 1, 1966 |
| University of Iowa Health Care Medical Center Downtown | Hospital | Other | Jan 31, 2024 |
| University of Iowa Health Care Medical Center Downtown Home Health | Home health agency | Other | Jan 31, 2024 |
Owned or controlled facilities with NPI records 4
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
Practitioners & affiliated clinicians
Practitioners 2,687
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Otolaryngology/Facial Plastic Surgery Physician
- Iowa City, IA
- NPI 1821082587
-
- Neurology Physician
- Iowa City, IA
- NPI 1861927204
-
- Physician Assistant
- Coralville, IA
- NPI 1780375576
-
- Vascular Surgery Physician
- Iowa City, IA
- NPI 1578962189
-
- Internal Medicine Physician
- Iowa City, IA
- NPI 1326022385
-
- Anesthesiology Physician
- Iowa City, IA
- NPI 1104874742
-
- Hospitalist Physician
- Iowa City, IA
- NPI 1710474259
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123545600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1714435200000",
"number": "1477554814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 HAWKINS DR",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522421009",
"telephone_number": "319-356-1616",
"fax_number": "319-384-5164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 HAWKINS DR",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "52242",
"telephone_number": "319-356-1616",
"fax_number": "319-384-5164"
}
],
"practiceLocations": [
{
"address_1": "920 E 2nd Ave Ste 201A&b",
"address_purpose": "LOCATION",
"city": "Coralville",
"state": "IA",
"postal_code": "522412219",
"country_code": "US",
"telephone_number": "319-467-2000",
"fax_number": "319-467-2410",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "105 E 9th St",
"address_purpose": "LOCATION",
"city": "Coralville",
"state": "IA",
"postal_code": "522412209",
"country_code": "US",
"telephone_number": "319-467-2000",
"fax_number": "319-467-2410",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2701 Prairie Meadow Dr",
"address_purpose": "LOCATION",
"city": "Iowa City",
"state": "IA",
"postal_code": "522428001",
"country_code": "US",
"telephone_number": "319-384-7070",
"fax_number": "319-467-8247",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "STATE UNIVERSITY OF IOWA",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "STATE UNIVERSITY OF IOWA",
"enumeration_date": "2005-08-09",
"last_updated": "2024-04-30",
"certification_date": "2024-04-30",
"status": "A",
"authorized_official_last_name": "VANDAELE",
"authorized_official_first_name": "DOUGLAS",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "ASSOCIATE DEAN",
"authorized_official_telephone_number": "319-353-8162",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "IA",
"license": null,
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "IA",
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": "IA",
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery",
"state": "IA",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BCBS OF IA",
"identifier": "33537",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004246",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "University of Iowa Health Care",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "University of Iowa Hospitals & Clinics/Medical Service Plan",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Iowa City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.