IOWA PLASTIC SURGERY CENTER LC (NPI# 1215916184) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215916184 |
| Entity Type | Organization |
| Organization Name | IOWA PLASTIC SURGERY CENTER LC |
| Practice Address |
4334 E 53rd St Davenport IA 52807-3039 |
| Practice Telephone | 5633228877 |
| Practice Fax Number | 5633228375 |
| Mailing Telephone | 5633228877 |
| Mailing Fax Number | 5633228375 |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2010-02-15 |
| Authorized Official Name | DR. BENJAMIN ADAM VANRAALTE (OWNER) |
| Authorized Official Telephone | 5633228877 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
29526 | IA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | IA0113241 | 05 |
| Street Address |
4334 E 53RD ST |
| City | DAVENPORT |
| State | IA |
| Zip Code | 52807-3039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659533040 | Iowa Plastic Surgery, PC | Specialist | 4334 E 53rd St, Davenport, IA 52807-3039 | 2008-06-27 |
| 1528048451 | Benjamin Vanraalte | Specialist | 4334 E 53rd St, Davenport, IA 52807-3039 | 2006-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710455423 | Sarah Duvall | Pharmacist | 2790 East 53rd Street, Davenport, IA 52807 | 2018-11-12 |
| 1932686375 | Costco Wholesale Corporation | Hearing Aid Equipment | 2790 East 53rd St., Davenport, IA 52807 | 2018-07-27 |
| 1902258379 | Secure Dental II, LLC | Dentist | 5025 Utica Ridge Rd, Suite 103, Davenport, IA 52807 | 2016-07-08 |
| 1003288663 | Kristin Landram | Pharmacist | 4011 E 53rd Street, Davenport, IA 52807 | 2015-10-22 |
| 1912384918 | Toshia Johnson | Counselor | 3515 Spring Street, Davenport, IA 52807 | 2015-04-29 |
| 1366849440 | Dennis Aaron Brown | Counselor | 2322 E. Kimberly Rd., Ste. 200 N., Davenport, IA 52807 | 2014-12-04 |
| 1033514914 | Rachel J Staron | Counselor | 2028 E 38th St Ste 3-5, Davenport, IA 52807 | 2014-11-04 |
| 1447651518 | Anthony B. Dexter | Chiropractor | 2178 E Kimberly Rd Ste 400, Davenport, IA 52807 | 2014-09-09 |
| 1932517588 | Alan Christopher Rubach | Dentist | 3435 Spring St Ste 2, Davenport, IA 52807 | 2014-07-28 |
| 1851707459 | Allison Maxwell | Behavioral Analyst | 4959 Utica Ridge Rd, Davenport, IA 52807 | 2014-07-03 |
| Find all providers in zip 52807 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912378357 | Davenport Ambulatory Surgery Center LLC | Clinic/Center | 107 Park Place Blvd, Davenport, FL 33837-6858 | 2015-10-12 |
| 1629420922 | Heart of Florida Surgery Center LLC | Clinic/Center | 410 Lionel Way, Davenport, FL 33837-7809 | 2016-07-11 |
| 1457709503 | Davenport Anesthesia Group LLC | Clinic/Center | 107 Park Place Blvd, Davenport, FL 33837-6858 | 2016-05-31 |
| 1619933835 | Mississippi Medical Plaza, Lc | Clinic/Center | 3400 Dexter Ct, #200, Davenport, IA 52807-3461 | 2006-04-25 |
| 1073516795 | Spring Park Surgery Center L L C | Clinic/Center | 3319 Spring St, Ste 202a, Davenport, IA 52807-2125 | 2005-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467010736 | Mercy Surgery Center LLC | Clinic/Center | 1195 Boyson Rd Ste 3, Hiawatha, IA 52233-2214 | 2019-06-03 |
| 1649748708 | Ankeny Medical Park Surgery Center Lc | Clinic/Center | 3625 N Ankeny Blvd Ste J, Ankeny, IA 50023-4610 | 2018-11-07 |
| 1922514421 | Westown Ambulatory Surgery Center | Clinic/Center | 1300 37th St Ste 3, West Des Moines, IA 50266-1900 | 2017-12-19 |
| 1255500781 | Iowa City Ambulatory Surgical Center, LLC | Clinic/Center | 2963 Northgate Dr, Iowa City, IA 52245-9571 | 2008-02-28 |
| 1699856260 | Alegent Health - Mercy Hospital, Corning Iowa | Clinic/Center | 603 Rosary Dr, Corning, IA 50841-1683 | 2006-10-18 |
| 1083638647 | West Des Moines Ambulatory Surgical Center Inc | Clinic/Center | 2425 Westown Pkwy Ste 200, West Des Moines, IA 50266 | 2006-07-27 |
| 1902841398 | Mason City Ambulatory Surgery Center, LLC | Clinic/Center | 990 4th St Sw, Mason City, IA 50401-2861 | 2006-06-18 |
| 1881651206 | Gateway Surgery Center, L.L.C. | Clinic/Center | 841 Springdale Dr, Clinton, IA 52732-3579 | 2006-04-28 |
| 1639135346 | Surgery Centers of Des Moines Ltd | Clinic/Center | 717 Lyon St, Des Moines, IA 50309-5458 | 2006-04-21 |
| 1780651075 | Fox Eye Surgery, LLC | Clinic/Center | 1138 H Ave Ne, Cedar Rapids, IA 52402-4624 | 2006-03-05 |
| Find all providers with the same taxonomy | ||||
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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.