NPIMap

Organization Active NPI

Polk County

Doing business as Polk County Health Department - Family Practice Clinic

  • Family Nurse Practitioner
  • Des Moines, IA
National Provider Identifier
1740579101
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
POLK COUNTY
Doing business as
Polk County Health Department - Family Practice Clinic
Practice address
1907 Carpenter Ave
Des Moines, IA 50314-1310
Phone
(515) 286-3798
Fax
(515) 286-2033
NPI assigned
Apr 6, 2011
Last updated
Jan 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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

Authorized official

Name
Mr. Juliann Van Liew
Title
Director
Phone
(515) 286-3767

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary

Addresses

Primary practice location

1907 Carpenter Ave
Des Moines, IA 50314-1310

Mailing address

1907 Carpenter Ave
Des Moines, IA 50314-1310
Phone (515) 875-5815

Other names 1

  • Polk County Health Department - Family Practice Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041006000640 IA Part B Supplier - Clinic/Group Practice 2860451812 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
Practice locations: Des Moines, IA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

  • Polk County

    dba Polk County Health Department

    • Public Health or Welfare Agency
    • Des Moines, IA
    • NPI 1588674675

    2860451812

    Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

  • Polk County

    dba Polk County Health Department

    • Public Health or Welfare Agency
    • Des Moines, IA
    • NPI 1588674675

    O20041006000640

    Same enrollment

National Provider Directory

National Provider Directory
Tax ID family
Polk County3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1907 Carpenter Ave
Des Moines, IA 50314
Phone (515) 286-3798

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767571200000",
    "number": "1740579101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 CARPENTER AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503141310",
            "telephone_number": "515-875-5815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 CARPENTER AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503141310",
            "telephone_number": "515-286-3798",
            "fax_number": "515-286-2033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLK COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-06",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A",
        "authorized_official_last_name": "VAN LIEW",
        "authorized_official_first_name": "JULIANN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "515-286-3767",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Polk County Health Department - Family Practice Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.