Austin Brown Clyde, DDS

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

RES-30693 Issued in IA

Practice address

200 Hawkins Dr
Iowa City, IA 52242-1049

Phone

(319) 356-2205

NPI assigned

Mar 19, 2024

Last updated

Oct 21, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1902666928",
    "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": "319-356-7340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421049",
            "telephone_number": "319-356-2205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Newton Rd",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522428004",
            "country_code": "US",
            "telephone_number": "319-356-2205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLYDE",
        "first_name": "AUSTIN",
        "middle_name": "BROWN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IA",
            "license": "RES-30693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Cleveland, M.D.
• Erin Lorene Cline, MSN, ARNP, FNP-C
• Amanda Susan Clingan, PTA
• Ellen Marie Cloyed
• Kathy Clubb
• Caitlin Coates, ARNP
• Katherine Cobb, T-LMFT
• Stuart Cobb, D.D.S.
• Janielle Cobler
• Annalisa Morgan Cochran, ARNP

• Student in an Organized Health Care Education/Training Program in Iowa City, IA
• Providers in Iowa City, IA by specialty
• Student in an Organized Health Care Education/Training Program in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.