Heartland Dermatolgy & Skin Cancer Center PC

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

Legal business name

HEARTLAND DERMATOLGY & SKIN CANCER CENTER PC

Practice address

12327 Stratford Dr
Clive, IA 50325-8148

Phone

(515) 224-7088

Fax

(515) 224-9228

NPI assigned

Nov 30, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Ava Risa Feldman, D.O.

Title

Co-Owner

Phone

(515) 224-7088

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gloria J Thielking, MPAS

  • Physician Assistant
  • Clive, IA
  • NPI 1053310656
  NPD

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196985600000",
    "number": "1891862033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12327 STRATFORD DR",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258148",
            "telephone_number": "515-224-7088",
            "fax_number": "515-224-9228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12327 STRATFORD DR",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258148",
            "telephone_number": "515-224-7088",
            "fax_number": "515-224-9228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND DERMATOLGY & SKIN CANCER CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-12-07",
        "status": "A",
        "authorized_official_last_name": "FELDMAN",
        "authorized_official_first_name": "AVA",
        "authorized_official_middle_name": "RISA",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "515-224-7088",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CN3179",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Xiaoping He, MD
• Mitchell J Heacock
• Healing Arts PLLC
• Healing Harbor Counseling LLC
• Healthy Sober Living Care LLC
• Heartland Healing LLC
• Charles Nathaniel Heggen, M.D.
• William Duncan Heggen, M.D.
• Kayla Heglin, LMSW
• Lais Heideman, RN

• Dermatopathology Physician in Clive, IA
• Providers in Clive, IA by specialty
• Dermatopathology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; 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.