Cornerstone Pediatrics and Family Allergy, PLC

Primary specialty

Allergy PhysicianTaxonomy code 207KA0200X

Legal business name

CORNERSTONE PEDIATRICS AND FAMILY ALLERGY, PLC

Practice address

6800 Lake Drive
#260
West Des Monies, IA 50266

Phone

(515) 822-3192

NPI assigned

Jun 17, 2019

Last updated

Jul 30, 2020By 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

Dr. Tara J FederlyNPI 1164683835

Title

Owner/Physician

Phone

(952) 546-6866

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 3

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.

• Tara J Federly, M.D.

  • Allergy Physician
  • West Des Moines, IA
  • NPI 1164683835
  Medicare reassignment NPD Authorized official
• Amy K. Petersen, D.O.

  • Pediatrics Physician
  • West Des Moines, IA
  • NPI 1730274523
  Medicare reassignment NPD
• Sherri Chrisman-Batterson, CPNP,ARNP

  • Pediatric Nurse Practitioner
  • Des Moines, IA
  • NPI 1275508020
  NPD (past)

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596067200000",
    "number": "1598325151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 LAKE DRIVE",
            "address_2": "#260",
            "city": "WEST DES MONIES",
            "state": "IA",
            "postal_code": "50266",
            "telephone_number": "515-822-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 LAKE DRIVE",
            "address_2": "#260",
            "city": "WEST DES MONIES",
            "state": "IA",
            "postal_code": "50266",
            "telephone_number": "515-822-3192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE PEDIATRICS AND FAMILY ALLERGY, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-17",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A",
        "authorized_official_last_name": "FEDERLY",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "952-546-6866",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iowa Total Care, Inc

• Allergy Physician in West Des Monies, IA
• Providers in West Des Monies, IA by specialty
• Allergy Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; 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.