Iowa Plastic Surgery, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

29526 Issued in IA

Legal business name

IOWA PLASTIC SURGERY, PC

Practice address

4334 E 53Rd St
Davenport, IA 52807-3039

Phone

(563) 322-8877

NPI assigned

Jun 27, 2008

Last updated

Jun 27, 2008By 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

Benjamin Adam Van Raalte, M.D.NPI 1528048451

Title

Owner

Phone

(563) 322-8877

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Benjamin Vanraalte, M.D.

  • Specialist
  • Davenport, IA
  • NPI 1528048451
  Authorized official Same address or phone
• Jeffrey Rhodes Dillow, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Leawood, KS
  • NPI 1013968007

  Specialist

  NPD (past)

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1659533040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4334 E 53RD ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073039",
            "telephone_number": "563-322-8877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4334 E 53RD ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073039",
            "telephone_number": "563-322-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA PLASTIC SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-27",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "VAN RAALTE",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "563-322-8877",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IA",
            "license": "29526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iowa Illinois Pain Consultants
• Iowa Illinois Pain Consultants P.C.
• Iowa Physicians Clinic Medical Foundation (Iowa Health Physicians)
• Iowa Physicians Eyecare Group, P.C.
• Iowa Plastic Surgery Center LC
• Ashlynn Ireland
• Penny Marie Irish, LMT
• Laura Irwin
• Virgie Lavette Islas, OTR/L
• Haruyo Izumi, A.T.C.

• Specialist in Davenport, IA
• Providers in Davenport, IA by specialty
• Specialist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.