Iowa Diagnostic Imaging & Procedure L C

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

IOWA DIAGNOSTIC IMAGING & PROCEDURE L C

Practice address

4200 University Ave
Suite 104
West Des Moines, IA 50266-5945

Phone

(515) 961-0453

Fax

(515) 961-2714

NPI assigned

Mar 4, 2014

Last updated

Jul 1, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cheri Tiedemann

Title

Billing Office Coordinator

Phone

(515) 961-0453

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Central Iowa Hospital Corp Member Other name

Locations

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

{
    "created_epoch": "1393891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656633600000",
    "number": "1508281205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 UNIVERSITY AVE",
            "address_2": "SUITE 104",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 UNIVERSITY AVE",
            "address_2": "SUITE 104",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665945",
            "telephone_number": "515-961-0453",
            "fax_number": "515-961-2714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA DIAGNOSTIC IMAGING & PROCEDURE L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-04",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A",
        "authorized_official_last_name": "TIEDEMANN",
        "authorized_official_first_name": "CHERI",
        "authorized_official_title_or_position": "BILLING OFFICE COORDINATOR",
        "authorized_official_telephone_number": "515-961-0453"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2073326",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Iowa Hospital Corp Member",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Central Iowa Hospital Corp Member",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Diagnostic Radiology Physician in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• Diagnostic Radiology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; 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.