NPIMap

Organization Active NPI

Diagnostic & Critical Care Medicine

  • Internal Medicine Physician
  • Des Moines, IA
National Provider Identifier
1932104593
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0000 Issued in IA
Legal business name
DIAGNOSTIC & CRITICAL CARE MEDICINE
Practice address
1510 Pleasant View Dr
Des Moines, IA 50315-2126
Phone
(515) 771-2527
Fax
(855) 642-1942
NPI assigned
Jun 20, 2005
Last updated
Dec 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Authorized official

Name
Mr. Mitch Harris
Title
Administrator
Phone
(515) 865-4567

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0000 IA Primary

Addresses

Primary practice location

1510 Pleasant View Dr
Des Moines, IA 50315-2126

Mailing address

411 Laurel St
Ste 3275
Des Moines, IA 50314-3027
Phone (515) 247-4113

Other identifiers 1

IdentifierTypeStateIssuer
0071233MedicaidIA

National Provider Directory

National Provider Directory

Locations

411 Laurel St
Ste 3
Des Moines, IA 50314

411 Laurel St
Ste 32
Des Moines, IA 50314
Phone (515) 247-4113

411 Laurel St
Ste 3275
Des Moines, IA 50314
Phone (515) 247-4113

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670889600000",
    "number": "1932104593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 LAUREL ST",
            "address_2": "STE 3275",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503143027",
            "telephone_number": "515-247-4113",
            "fax_number": "515-643-8779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 PLEASANT VIEW DR",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503152126",
            "telephone_number": "515-771-2527",
            "fax_number": "855-642-1942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC & CRITICAL CARE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-20",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "MITCH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "515-865-4567",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "0000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0071233",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Dec 13, 2022; 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.