Central Iowa Dermatology LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

CENTRAL IOWA DERMATOLOGY LLC

Practice address

230 62ND CT
West Des Moines, IA 50266-8602

Phone

(515) 726-3376

Fax

(515) 446-9707

NPI assigned

Jan 25, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Eric Allen Harlan, MDNPI 1487809190

Title

Owner/Medical Director

Phone

(319) 321-3515

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Locations

Practitioners 5

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

• Eric Allen Harlan, MD

  • Dermatology Physician
  • Johnston, IA
  • NPI 1487809190
  Medicare reassignment Care Compare group NPD Authorized official
• Elizabeth A Foutch, PA

  • Physician Assistant
  • Johnston, IA
  • NPI 1194519256
  Medicare reassignment Care Compare group NPD
• Emily R Erickson, PA-C

  • Medical Physician Assistant
  • Des Moines, IA
  • NPI 1376776898
  Medicare reassignment Care Compare group
• Betsy Lucille Van Haaften, PA-C

  • Medical Physician Assistant
  • Johnston, IA
  • NPI 1023609690
  Medicare reassignment Care Compare group
• Catherine Ann Carlson

  • Physician Assistant
  • Gainesville, GA
  • NPI 1346656980

  IA

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1548374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548374400000",
    "number": "1922562743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 62ND CT",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502668602",
            "telephone_number": "515-726-3376",
            "fax_number": "515-446-9707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 62ND CT",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502668602",
            "telephone_number": "515-726-3376",
            "fax_number": "515-446-9707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL IOWA DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-25",
        "last_updated": "2019-01-25",
        "status": "A",
        "authorized_official_last_name": "HARLAN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "319-321-3515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• Dermatology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2019; 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.