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JORDAN CREEK FAMILY MEDICAL CLINIC PC NPI 1356378772


NPI Information

NPI: 1356378772
Provider Name: JORDAN CREEK FAMILY MEDICAL CLINIC PC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 16D1056664

Address:
230 S 68TH ST
SUITE 220
WEST DES MOINES, IA
ZIP 50266
Phone: (515) 457-8517
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JORDAN CREEK FAMILY MEDICAL CLINIC PC is a family medicine in West Des Moines, IA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. JORDAN CREEK FAMILY MEDICAL CLINIC PC NPI is 1356378772. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

230 S 68TH ST
SUITE 220
WEST DES MOINES, IA
ZIP 50266-176
Phone: (515) 457-8517

The provider's authorized official is Basil Saadi Hassan .
The authorized official title is President/ceo and has the following contact phone number (515) 457-8517.

The CLIA number assigned to this NPI record is 16D1056664 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/28/2006 and was last updated on 8/22/2020.


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
1207Q00000XFamily Medicine35490IOWAYes

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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