Obstetric and Gynecologic Associates of Iowa City PC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

OBSTETRIC AND GYNECOLOGIC ASSOCIATES OF IOWA CITY PC

Practice address

2769 Heartland Dr
Suite 201
Coralville, IA 52241-2732

Phone

(319) 337-3193

Fax

(319) 545-4570

NPI assigned

Sep 7, 2005

Organization subpart

No

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

Authorized official

Name

Lori S Wenzel, M.D.

Title

President

Phone

(319) 337-3193

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323302400000",
    "number": "1700870649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2769 HEARTLAND DR",
            "address_2": "SUITE 201",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522412732",
            "telephone_number": "319-337-3193",
            "fax_number": "319-545-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2769 HEARTLAND DR",
            "address_2": "SUITE 201",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522412732",
            "telephone_number": "319-337-3193",
            "fax_number": "319-545-4570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBSTETRIC AND GYNECOLOGIC ASSOCIATES OF IOWA CITY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-07",
        "last_updated": "2011-12-08",
        "status": "A",
        "authorized_official_last_name": "WENZEL",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "319-337-3193",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0089979",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "08997",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "A002306",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "CP8135",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Coralville, IA
• Providers in Coralville, IA by specialty
• Obstetrics & Gynecology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; 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.