BROADLAWNS MEDICAL CENTER NPI 1669693917

NPI Information

NPI: 1669693917
Provider Name: BROADLAWNS MEDICAL CENTER
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
1801 HICKMAN ROAD
DES MOINES, IA
ZIP 50314
Phone: (515) 282-2200
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BROADLAWNS MEDICAL CENTER is a foot and ankle surgery podiatrist in Des Moines, IA. BROADLAWNS MEDICAL CENTER NPI is 1669693917. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1801 HICKMAN ROAD
DES MOINES, IA
ZIP 50314-548
Phone: (515) 282-2200

The provider's authorized official is Vincent J Mandracchia .
The authorized official title is Chief Medical Officer and has the following contact phone number (515) 282-2562.

The enumeration date for this NPI number is 5/2/2007 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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0103X	Podiatrist	Foot & Ankle Surgery	000581	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	20023	OTHER	IOWA	TRICARE
2	A5031401	OTHER	IOWA	JOHN DEERE, UHC RIVER VAL
3	29705	OTHER	IOWA	COVENTRY
4	2601013	OTHER	IOWA	IOWA CARE
5	0432567	MEDICAID	IOWA
6	6230290	OTHER	IOWA	AETNA

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: 11/14/2023

NPI Synchronization or Removal

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