Active NPI
Lauris C Kaldjian, MD
- Internal Medicine Physician
- Coralville, IA
National Provider Identifier
1790772051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 33692
- Practice address
- 105 E 9TH St
Coralville, IA 52241 - Phone
- (319) 467-2000
- Fax
- (319) 467-2410
- NPI assigned
- Oct 3, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | 33692 | IA | |
| Internal Medicine Physician | 207R00000X | 33692 | IA | Primary |
Addresses
Primary practice location
105 E 9TH St
Coralville, IA 52241
Mailing address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 335-6706
Other practice location 1
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 335-6706
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0218891 | Medicaid | IA | |
| 24471 | Other | IA | WELLMARK BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33692 | IA | MD | Infectious Disease Physician |
Interoperability endpoints
- lkaldjian11589@uihcdirect.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528934400000",
"number": "1790772051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 HAWKINS DR",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522421009",
"telephone_number": "319-335-6706",
"fax_number": "319-356-3086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 E 9TH ST",
"city": "CORALVILLE",
"state": "IA",
"postal_code": "52241",
"telephone_number": "319-467-2000",
"fax_number": "319-467-2410"
}
],
"practiceLocations": [
{
"address_1": "200 Hawkins Dr",
"address_purpose": "LOCATION",
"city": "Iowa City",
"state": "IA",
"postal_code": "522421009",
"country_code": "US",
"telephone_number": "319-335-6706",
"fax_number": "319-356-3086",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KALDJIAN",
"first_name": "LAURIS",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-03",
"last_updated": "2018-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "IA",
"license": "33692",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IA",
"license": "33692",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0218891",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BCBS",
"identifier": "24471",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coralville, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.