Iowa Physicians Clinic Medical Foundation

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION

Doing business as

Indianola Family Medicine

Practice address

301 E Hillcrest Ave
Indianola, IA 50125-9027

Phone

(515) 961-3700

Fax

(515) 961-6574

NPI assigned

May 5, 2006

Last updated

Aug 16, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

IOWA PHYSICIANS CLINIC MEDICAL FOUNDATIONAs reported in NPPES

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

Authorized official

Name

Erick J Laine

Title

Coo

Phone

(515) 471-9227

Specialties & licenses 1

Addresses

Other names 1

• Indianola Family Medicine Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Iowa Phy Medical Foundation

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345075200000",
    "number": "1992754220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 BIRCHWOOD CT",
            "address_2": "SUITE R",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312930",
            "telephone_number": "515-471-9372",
            "fax_number": "515-471-9319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E HILLCREST AVE",
            "city": "INDIANOLA",
            "state": "IA",
            "postal_code": "501259027",
            "telephone_number": "515-961-3700",
            "fax_number": "515-961-6574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION",
        "enumeration_date": "2006-05-05",
        "last_updated": "2012-08-16",
        "status": "A",
        "authorized_official_last_name": "LAINE",
        "authorized_official_first_name": "ERICK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "515-471-9227"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Indianola Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Indianola Ia Skilled Nursing Facility, LLC
• Indianola Pediatric Dentistry
• Indianola Residential, LLC (Indianola Residential)
• Iowa Dental Health Professionals, P.C. (Dental Professionals)
• Iowa Hearing Instruments LLC (Miracle Ear)
• Iowa Speech Therapy
• Gary Lee Jacobsen, DDS
• Gary Janssen, DO
• Alfreda Jarue
• Jaybird ABA LLC (Jaybird ABA)

• Durable Medical Equipment & Medical Supplies in Indianola, IA
• Providers in Indianola, IA by specialty
• Durable Medical Equipment & Medical Supplies in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.