NPIMap

Organization Active NPI

Iowa Diagnostic Imaging & Procedure Center, L C

Doing business as Iowa Radiology, P.C.

  • Diagnostic Radiology Physician
  • Clive, IA
National Provider Identifier
1528026481
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
IOWA DIAGNOSTIC IMAGING & PROCEDURE CENTER, L C
Doing business as
Iowa Radiology, P.C.
Practice address
12368 Stratford Dr
Suite 300
Clive, IA 50325-8162
Phone
(515) 226-9810
Fax
(515) 226-8408
NPI assigned
May 2, 2006
Last updated
Jul 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Authorized official

Name
Cheri K. Tiedemann
Title
Billing Office Coordinator
Phone
(515) 961-0453

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

12368 Stratford Dr
Suite 300
Clive, IA 50325-8162

Mailing address

12368 Stratford Dr
Suite 300
Clive, IA 50325-8162
Phone (515) 226-9810

Other names 1

  • Iowa Radiology, P.C. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, LA, MN, AK, HI, OK, MO, FL, KS9 enrollments

Enrollment records 9

Enrollment IDStateProvider typePAC IDDetails
O20040325001707 IA Part B Supplier - Clinic/Group Practice 1658263546 Receives reassigned benefits from 39 practitioners
Practice locations: Clive, IA; West Des Moines, IA; Waukee, IA; Des Moines, IA; Ankeny, IA
O20180319002287 LA Part B Supplier - Clinic/Group Practice 1658263546 Receives reassigned benefits from 1 practitioner
Practice locations: Mandeville, LA
O20181022000882 MN Part B Supplier - Clinic/Group Practice 1658263546 Receives reassigned benefits from 1 practitioner
Practice locations: Woodbury, MN
O20181025001200 AK Part B Supplier - Clinic/Group Practice 1658263546 Receives reassigned benefits from 1 practitioner
Practice locations: Wasilla, AK
O20220706000322 HI Part B Supplier - Clinic/Group Practice 1658263546 Receives reassigned benefits from 1 practitioner
Practice locations: Honolulu, HI
O20230125001398 OK Part B Supplier - Clinic/Group Practice 1658263546 Receives reassigned benefits from 1 practitioner
Practice locations: Poteau, OK
O20241031002074 MO Part B Supplier - Clinic/Group Practice 1658263546 Receives reassigned benefits from 1 practitioner
Practice locations: Marshfield, MO
O20241220001622 FL Part B Supplier - Clinic/Group Practice 1658263546 Receives reassigned benefits from 2 practitioners
Practice locations: Bonita Springs, FL
O20250328000580 KS Part B Supplier - Clinic/Group Practice 1658263546 Receives reassigned benefits from 1 practitioner
Practice locations: Leawood, KS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D1093195Iowa Diagnostic Imaging and Procedure Center12368 Stratford Drive, Clive, IA 50325Certificate of waiverDec 10, 2026

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1105 N Ankeny Blvd
Ste 200
Ankeny, IA 50023

3625 N Ankeny Blvd
Ste H
Ankeny, IA 50023

12368 Stratford Dr
Clive, IA 50325

1221 Pleasant St
Ste 350
Des Moines, IA 50309

6000 University Ave
Ste 15
West Des Moines, IA 50266

6000 University Ave
Ste 150
West Des Moines, IA 50266

Practitioners & affiliated clinicians

Practitioners 46

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656633600000",
    "number": "1528026481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12368 STRATFORD DR",
            "address_2": "SUITE 300",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258162",
            "telephone_number": "515-226-9810",
            "fax_number": "515-226-8408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12368 STRATFORD DR",
            "address_2": "SUITE 300",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258162",
            "telephone_number": "515-226-9810",
            "fax_number": "515-226-8408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA DIAGNOSTIC IMAGING & PROCEDURE CENTER, L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A",
        "authorized_official_last_name": "TIEDEMANN",
        "authorized_official_first_name": "CHERI",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "BILLING OFFICE COORDINATOR",
        "authorized_official_telephone_number": "515-961-0453"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Iowa Radiology, P.C.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Iowa Radiology, P.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clive, IA

Sources for this page

  • 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.