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DES MOINES PEDIATRIC & ADOLESCENT CLINIC NPI 1194991109


NPI Information

NPI: 1194991109
Provider Name: DES MOINES PEDIATRIC & ADOLESCENT CLINIC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 16D0383437

Address:
2301 BEAVER AVE
DES MOINES, IA
ZIP 50310
Phone: (515) 255-3181
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DES MOINES PEDIATRIC & ADOLESCENT CLINIC is a pediatrics in Des Moines, IA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DES MOINES PEDIATRIC & ADOLESCENT CLINIC NPI is 1194991109. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

2301 BEAVER AVE
DES MOINES, IA
ZIP 50310-903
Phone: (515) 255-3181
Fax: (515) 255-9392

The provider's authorized official is Rob Fornoff .
The authorized official title is Owner and has the following contact phone number (515) 255-3181.

The CLIA number assigned to this NPI record is 16D0383437 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 4/30/2008 and was last updated on 12/10/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes
2363LP0200XNurse PractitionerPediatricsNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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