PHYLLIS CHANG, M.D., PLC (NPI# 1083780266) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083780266 |
| Entity Type | Organization |
| Organization Name | PHYLLIS CHANG, M.D., PLC |
| Practice Address |
604 5th St Coralville IA 52241-2304 |
| Mailing Address |
604 5th St Po Box 5036 Coralville IA 52241-2304 |
| Practice Telephone | 3193588788 |
| Practice Fax Number | 3193519278 |
| Mailing Telephone | 3193588788 |
| Mailing Fax Number | 3193519278 |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. PHYLLIS CHANG (MEMBER) |
| Authorized Official Telephone | 3193588788 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2082S0105X |
Plastic Surgery Specialization: Surgery of the Hand |
26997 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0450049 | 05 |
| Street Address |
604 5TH ST |
| City | CORALVILLE |
| State | IA |
| Zip Code | 52241-2304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407922768 | Phyllis Chang | Plastic Surgery | 604 5th St, Coralville, IA 52241-2304 | 2006-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780281915 | Impact Physician Group Iowa LLC | Internal Medicine | 2801 Heartland Dr, Coralville, IA 52241 | 2020-10-01 |
| 1114550886 | Encompass Health Rehabilitation Hospital of Iowa City, LLC | Rehabilitation Hospital | 2450 Coral Court, Coralville, IA 52241 | 2020-02-20 |
| 1215575394 | Eastern Iowa Rehabilitation Hospital, LLC | Rehabilitation Hospital | 2801 Heartland Drive, Coralville, IA 52241 | 2019-12-19 |
| 1851938690 | Matthew Easley | Speech-Language Pathologist | 2854 Coral Court, Ste 1, On With Life Outpatient Neuro Rehabilitation, Coralville, IA 52241 | 2019-11-27 |
| 1245892629 | On With Life, Inc | Clinic/Center | 2854 Coral Court, Suite 1, Coralville, IA 52241 | 2019-07-05 |
| 1376024869 | Hy Vee Inc | Pharmacy | 3285 Crosspark Road, Coralville, IA 52241 | 2018-08-23 |
| 1861996191 | Roggy Vision Center, Pllc | Optometrist | 708 5th St Ste 1, Coralville, IA 52241 | 2018-03-21 |
| 1013446467 | Monica Basile | Midwife | 501 12th Ave, St 102, Coralville, IA 52241 | 2017-06-08 |
| 1568893121 | Mohamed Karim | Chiropractor | 1801 Brown Deer Trail, Coralville, IA 52241 | 2013-12-09 |
| 1689011405 | Nicole Ann Wagaman | Family Medicine | 2801 Heartland Dr., Coralville, IA 52241 | 2013-06-03 |
| Find all providers in zip 52241 | ||||
| Taxonomy Code | 2082S0105X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| Specialization | Surgery of the Hand |
| A plastic surgeon with additional training in the investigation, preservation, and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407922768 | Phyllis Chang | Plastic Surgery | 604 5th St, Coralville, IA 52241-2304 | 2006-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821058637 | Scott Matthew Shumway | Plastic Surgery | 450 Laurel St, Ste. A, Des Moines, IA 50314-3045 | 2006-03-24 |
| City | CORALVILLE |
| Zip Code | 52241 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.