# IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619309325
- **Authorized official:** ERICK LAINE (EXEC VP/COO)
- **Authorized official phone:** (515) 471-9227

## Contact information

- **Practice address:** 8101 BIRCHWOOD CT, SUITE N, JOHNSTON, IA 50131-2930
- **Practice address phone:** (515) 471-9300
- **Practice address fax:** (515) 471-9320
- **Mailing address:** PO BOX 658, DES MOINES, IA 50303-0658
- **Mailing address phone:** (515) 471-9300
- **Mailing address fax:** (515) 471-9320

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | — |
| 1223D0001X | Public Health Dentistry | — | — | — |
| 207P00000X | Emergency Medicine Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 207RI0200X | Infectious Disease Physician | — | — | — |
| 207T00000X | Neurological Surgery Physician | — | — | — |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | — | — |
| 208D00000X | General Practice Physician | — | — | Yes |
| 208M00000X | Hospitalist Physician | — | — | — |
| 225100000X | Physical Therapist | — | — | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 08/05/2013
- **Last updated:** 08/05/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1366425274 | — | IA |
| 01 | — | CC6519 | RR MEDICARE | IA |
| 01 | — | CC6757 | RR MEDICARE | IA |
| 01 | — | CC7716 | RR MEDICARE | IA |
| 01 | — | CI6362 | RR MEDICARE | IA |
| 01 | — | CJ3564 | RR MEDICARE | IA |