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 Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 261Q00000X | Clinic/Center | | 01709 | IOWA | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 17996 | OTHER | IOWA | WELLMARK BLUE SHIELD |
| 2 | 17996 | OTHER | IOWA | MUTUAL OF OMAHA |
| 3 | ========= | OTHER | IOWA | DEFINITY HEALTH |
| 4 | ========= | OTHER | IOWA | EVERCARE |
| 5 | ========= | OTHER | IOWA | MAILHANDLERS |
| 6 | ========= | OTHER | IOWA | AUTO OWNERS, PRAIRIE STATES |
| 7 | ========= | OTHER | IOWA | AMERICARE |
| 8 | ========= | OTHER | IOWA | MED BEN |
| 9 | ========= | OTHER | IOWA | AMERICAN REPUBLIC |
| 10 | 6155 | OTHER | IOWA | MIDLANDS CHOICE |
| 11 | ========= | OTHER | IOWA | UNICARE |
| 12 | ========= | OTHER | IOWA | GUARANTEE TRUST LIFE INS. CO. |
| 13 | 17996 | MEDICARE PIN | IOWA | |
| 14 | ========= | OTHER | IOWA | TODAY'S OPTIONS |
| 15 | ========= | OTHER | IOWA | UNITED AMERICAN INSURANCE COMPANY |
| 16 | 410020694 | OTHER | IOWA | RAILROAD MEDICARE |
| 17 | 81376 | OTHER | IOWA | COVENTRY ADVANTRA |
| 18 | ========= | OTHER | IOWA | PIRELLI ARMSTRONG |
| 19 | ========= | OTHER | IOWA | SECUREHORIZONS |
| 20 | ========= | OTHER | IOWA | EBC (EMPLOYEE BENEFIT CONSULTANTS) |
| 21 | ========= | OTHER | IOWA | GLACIERS LOCAL #558 |
| 22 | ========= | OTHER | IOWA | HUMANA |
| 23 | ========= | OTHER | IOWA | AARP |
| 24 | 0000 | OTHER | IOWA | TRIWEST |
| 25 | 81376 | OTHER | IOWA | COVENTRY HEALTHCARE |
| 26 | 81376 | OTHER | IOWA | ADVANTRA FREEDOM |
| 27 | ========= | OTHER | IOWA | BRIDGESTONE/FIRESTONE |
| 28 | IA0101 | OTHER | IOWA | UNITED HEALTHCARE OF THE RIVER VALLEY |
| 29 | ========= | OTHER | IOWA | SOUTHERN BENEFIT ADMINISTRATORS INC |
| 30 | T01037 | MEDICARE UPIN | IOWA | |
| 31 | ========= | OTHER | IOWA | BANKERS LIFE |
| 32 | ========= | OTHER | IOWA | ADVANTICA EYECARE |
| 33 | 0005314 | MEDICAID | IOWA | |
| 34 | 17996 | OTHER | IOWA | FIRST ADMINISTRATORS |
| 35 | ========= | OTHER | IOWA | FEDERATED INSURANCE |
| 36 | ========= | OTHER | IOWA | MEDICARE COMPLETE |
| 37 | ========= | OTHER | IOWA | PRINCIPAL HEALTHCARE |
| 38 | ========= | OTHER | IOWA | CENTRAL RESERVE |
| 39 | ========= | OTHER | IOWA | ACCOUNTABLE HEALTH |
| 40 | ========= | OTHER | IOWA | UNITED HEALTHCARE |
