NPIMap

Organization Active NPI

Iowa Ear Center

  • Specialist
  • Clive, IA
National Provider Identifier
1780818138
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
38032 Issued in IA
Legal business name
IOWA EAR CENTER
Practice address
12499 University Ave
Suite 200
Clive, IA 50325-8288
Phone
(515) 418-9960
Fax
(515) 418-9107
NPI assigned
May 13, 2009
Last updated
Jan 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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

Authorized official

Name
Meagan E Mostrom, COPM
Title
Practice Manager
Phone
(515) 207-4026

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 38032 IA Primary

Addresses

Primary practice location

12499 University Ave
Suite 200
Clive, IA 50325-8288

Mailing address

12499 University Ave
Suite 200
Clive, IA 50325-8288
Phone (515) 418-9960

Other identifiers 1

IdentifierTypeStateIssuer
1780818138MedicaidIA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address meagankay@iec.drchronodirect.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090610000389 IA Part B Supplier - Clinic/Group Practice 2264582493 Receives reassigned benefits from 13 practitioners
Practice locations: Clive, IA; Newton, IA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: meagankay@iec.drchronodirect.com

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1242172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578528000000",
    "number": "1780818138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12499 UNIVERSITY AVE",
            "address_2": "SUITE 200",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258288",
            "telephone_number": "515-418-9960",
            "fax_number": "515-418-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12499 UNIVERSITY AVE",
            "address_2": "SUITE 200",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258288",
            "telephone_number": "515-418-9960",
            "fax_number": "515-418-9107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA EAR CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-13",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A",
        "authorized_official_last_name": "MOSTROM",
        "authorized_official_first_name": "MEAGAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "515-207-4026",
        "authorized_official_credential": "COPM"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IA",
            "license": "38032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780818138",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "meagankay@iec.drchronodirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct messaging",
            "address_1": "12499 University Ave",
            "address_2": "Suite 200",
            "city": "Clive",
            "state": "IA",
            "country_code": "US",
            "postal_code": "503258288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; 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.