HEALTHY AGING AND MEMORY CLINIC (NPI# 1417044645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417044645 |
| Entity Type | Organization |
| Organization Name | HEALTHY AGING AND MEMORY CLINIC |
| Practice Address |
1300 50th Street Suite 104 West Des Moines IA 50266 |
| Mailing Address |
2555 106th Street Urbandale IA 50322-3766 |
| Practice Telephone | 5152244100 |
| Practice Fax Number | 5152244926 |
| Mailing Telephone | 5153347524 |
| Mailing Fax Number | 5153347528 |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2011-10-04 |
| Authorized Official Name | DR. ROBERT L BENDER II (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 5152244100 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
22610 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 2184259 | 05 |
| Street Address |
1300 50TH STREET SUITE 104 |
| City | WEST DES MOINES |
| State | IA |
| Zip Code | 50266 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952333569 | Joseph C Bennett | Chiropractor | 1300 50th Street, Lower Level-suite 106, West Des Moines, IA 50266-5499 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013544667 | Annie Penquite | Physician Assistant | 6001 Westown Pwky, West Des Moines, IA 50266 | 2020-03-24 |
| 1730733205 | Erin Allyn Fiala | Counselor | 1200 Valley West Dr Suite 508, West Des Moines, IA 50266 | 2019-08-01 |
| 1598325151 | Cornerstone Pediatrics and Family Allergy, Plc | Pediatrics | 6800 Lake Drive, #260, West Des Monies, IA 50266 | 2019-06-17 |
| 1093286395 | Ccrc of West Des Moines, LLC | Skilled Nursing Facility | 8950 Coachlight Drive, West Des Moines, IA 50266 | 2018-12-12 |
| 1326517400 | Merit Hearing LLC | Audiologist-Hearing Aid Fitter | 2910 Westown Pkwy Ste 110, West Des Moines, IA 50266 | 2018-11-18 |
| 1699253807 | Diamond Home Health Care Services | Home Health | 4949 Weston Pkwy Ste 165 #836, West Des Moines, IA 50266 | 2018-07-31 |
| 1285129932 | Hy Vee Inc | Pharmacy | 375 South Jordan Creek Parkway, West Des Moines, IA 50266 | 2018-06-26 |
| 1669965208 | Rx Precision, Inc. | Case Management | 6205 Mills Civic Pkwy Ste 201, West Des Moines, IA 50266 | 2018-06-08 |
| 1912406588 | Cora Schuhmacher, Psy.d., Pllc | Psychologist | 1045 76th St Unit 3030, West Des Moines, IA 50266 | 2018-02-08 |
| 1508374778 | Brian L Bentley | Counselor | 5500 Wild Rose Lane, Suite 400, West Des Moines, IA 50266 | 2018-01-22 |
| Find all providers in zip 50266 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386758613 | Roy William Overton IIi | Family Medicine | 5927 Highland Cir, West Des Moines, IA 50266-2825 | 2006-08-17 |
| 1518214204 | Long Term Care Services PC | Family Medicine | 5927 Highland Cir, West Des Moines, IA 50266-2825 | 2012-08-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316357494 | Kayla Leigh Ehrman | Family Medicine | 2535 Maplecrest Rd Ste 16, Bettendorf, IA 52722 | 2014-04-29 |
| 1447363700 | Robert D Conner | Family Medicine | 13435 University Ave, Suite 500, Clive, IA 50325-8249 | 2006-08-17 |
| 1124026489 | Family Medicine Clinic | Family Medicine | 600 9th Ave N, Sibley, IA 51249-1012 | 2005-07-11 |
| 1942702501 | Hildegard Janouschek | Family Medicine | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2018-02-28 |
| 1174933998 | Metro Geriatric Services | Family Medicine | 13435 University Ave, Suite 500, Clive, IA 50325-8249 | 2014-05-01 |
| 1003173980 | Scott Thomas Hanson | Family Medicine | 1540 High St, Suite 101, Des Moines, IA 50309-3106 | 2012-04-18 |
| 1821301060 | Stephen Jeffrey Nickelburg | Family Medicine | 3600 30th Street, Va Central Iowa Health Care System, Des Moines, IA 50310-5885 | 2010-07-16 |
| 1285814681 | Mercy Clinics Inc | Family Medicine | 95 University Ave, Suite 8, Des Moines, IA 50314-3120 | 2007-11-14 |
| 1457322216 | Maher Saegh | Family Medicine | 1111 6th Ave, Des Moines, IA 50314-2613 | 2006-01-30 |
| City | WEST DES MOINES |
| Zip Code | 50266 |
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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.