Digestive Health Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

DIGESTIVE HEALTH CENTER LLC

Practice address

1015 S Hackett Rd Ste B
Waterloo, IA 50701-3500

Phone

(319) 406-5990

Fax

(319) 429-7950

NPI assigned

Apr 23, 2021

Organization subpart

No

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

Authorized official

Name

Ravindra Mallavarapu, MDNPI 1982657961

Title

President

Phone

(319) 234-5990

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Listed as

Digestive Health Center LLCCCN 16C0001036

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ravindra Mallavarapu, MD

  • Gastroenterology Physician
  • Waterloo, IA
  • NPI 1982657961
  NPD Authorized official

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

{
    "created_epoch": "1619136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619136000000",
    "number": "1548842180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2758",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507042758",
            "telephone_number": "319-235-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 S HACKETT RD STE B",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507013500",
            "telephone_number": "319-406-5990",
            "fax_number": "319-429-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGESTIVE HEALTH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-23",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A",
        "authorized_official_last_name": "MALLAVARAPU",
        "authorized_official_first_name": "RAVINDRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "319-234-5990",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Dibben, LMSW
• Jennifer Diemer, MT-BC
• Diercks Senior Care LLC
• Candace Lee Diercks
• Rodney Dieser
• Kelly Marie Dighton, PHARM.D
• Taylor Digmann, DPT, ATC
• Lauma Dimpere, PHARMD
• Kevin J Dirksen, ARNP
• Grace Distler

• Ambulatory Surgical Clinic/Center in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Ambulatory Surgical Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; 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.