NPIMap

Organization Active NPI

Stadia Sports Medicine PC

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • West Des Moines, IA
National Provider Identifier
1962453274
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X
License
36501 Issued in IA
Legal business name
STADIA SPORTS MEDICINE PC
Practice address
7601 Office Plaza Dr N Ste 140
West Des Moines, IA 50266-1207
Phone
(515) 221-1102
Fax
(515) 221-1272
NPI assigned
May 12, 2006
Last updated
Jul 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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

Authorized official

Name
Dr. Chad Thomas Carlson, M.D.NPI 1326008368
Title
Ceo, Stadia Sports Medicine
Phone
(515) 221-1102

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 204C00000X 36501 IA Primary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X

Addresses

Primary practice location

7601 Office Plaza Dr N Ste 140
West Des Moines, IA 50266-1207

Mailing address

7601 Office Plaza Dr N Ste 140
West Des Moines, IA 50266-1207
Phone (515) 221-1102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060804000090 IA Part B Supplier - Clinic/Group Practice 4284647579 Receives reassigned benefits from 14 practitioners
Practice locations: West Des Moines, IA
O20240528000715 IA DME Supplier - Multi-Specialty - Physician 4284647579 Practice locations: West Des Moines, IA

National Provider Directory

National Provider Directory

Locations

7601 Office Plaza Dr N
Ste 140
West Des Moines, IA 50266
Phone (515) 221-1102

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783641600000",
    "number": "1962453274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 OFFICE PLAZA DR N STE 140",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661207",
            "telephone_number": "515-221-1102",
            "fax_number": "515-221-1272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 OFFICE PLAZA DR N STE 140",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661207",
            "telephone_number": "515-221-1102",
            "fax_number": "515-221-1272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STADIA SPORTS MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "CEO, STADIA SPORTS MEDICINE",
        "authorized_official_telephone_number": "515-221-1102",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "IA",
            "license": "36501",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; 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.