NPIMap

Organization Active NPI

Iowa Dermatology Clinic PLC

Doing business as Radiant Complexions Dermatology Clinics or Radiant Pathology

  • Dermatology Physician
  • Des Moines, IA
National Provider Identifier
1871607531
Registry record updated Apr 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
IOWA DERMATOLOGY CLINIC PLC
Doing business as
Radiant Complexions Dermatology Clinics or Radiant Pathology
Practice address
5921 SE 14TH St
Suite 2500
Des Moines, IA 50320-1746
Phone
(515) 287-5757
Fax
(515) 287-0063
NPI assigned
Aug 19, 2006
Last updated
Apr 22, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2016

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

Authorized official

Name
Mr. Andrew B Karas, MBA
Title
Cfo
Phone
(515) 226-3116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

5921 SE 14TH St
Suite 2500
Des Moines, IA 50320-1746

Mailing address

6000 University Ave
Suite 350
West Des Moines, IA 50266-8203
Phone (515) 226-3116

Other names 1

  • Radiant Complexions Dermatology Clinics or Radiant Pathology Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461283200000",
    "number": "1871607531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 UNIVERSITY AVE",
            "address_2": "SUITE 350",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502668203",
            "telephone_number": "515-226-3116",
            "fax_number": "515-391-9262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5921 SE 14TH ST",
            "address_2": "SUITE 2500",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503201746",
            "telephone_number": "515-287-5757",
            "fax_number": "515-287-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA DERMATOLOGY CLINIC PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2016-04-22",
        "status": "A",
        "authorized_official_last_name": "KARAS",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "515-226-3116",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Radiant Complexions Dermatology Clinics or Radiant Pathology",
            "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 Apr 22, 2016; 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.