BROADLAWNS MEDICAL CENTER (NPI# 1528182615) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528182615 |
| Entity Type | Organization |
| Organization Name | BROADLAWNS MEDICAL CENTER |
| Other Organization Name | BROADLAWNS MEDICAL CENTER EMERGENCY DEPARTMENT |
| Practice Address |
1801 Hickman Road Des Moines IA 50314-1548 |
| Practice Telephone | 5152822200 |
| Mailing Telephone | 5152822200 |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. VINCENT J MANDRACCHIA (CHIEF MEDICAL OFFICER) |
| Authorized Official Telephone | 5152822562 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 26518 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | JOHN DEERE, UHC RIVER VAL | A5031401 | 01 |
| IA | AETNA | 6230290 | 01 |
| IA | COVENTRY | 29705 | 01 |
| IA | 0427476 | 05 | |
| IA | TRICARE | 20023 | 01 |
| Other Name | Type Code |
|---|---|
| Broadlawns Medical Center Emergency Department | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609951144 | Broadlawns Medical Center | Community Based Residential Treatment Facility, Mental Illness | 1812 Oakland Ave, Des Moines, IA 50314-3329 | 2006-10-25 |
| 1336224872 | Broadlawns Medical Center | Community Based Residential Treatment Facility, Mental Illness | 1730 Arlington Ave, Des Moines, IA 50314-3311 | 2006-10-25 |
| 1578002382 | Broadlawns Medical Center | Psychiatric Unit | 1801 Hickman Rd, Des Moines, IA 50314-1505 | 2017-02-14 |
| 1467850727 | Broadlawns Medical Center | Clinic/Center | 507 14th St, Dallas Center, IA 50063-7738 | 2014-12-18 |
| 1235541434 | Broadlawns Medical Center | Eyewear Supplier (Equipment, not the service) | 1801 Hickman Rd, Des Moines, IA 50314-1505 | 2014-05-22 |
| 1063795672 | Broadlawns Medical Center | Psychiatric Hospital | 1801 Hickman Rd, Des Moines, IA 50314-1505 | 2011-09-21 |
| 1669784104 | Broadlawns Medical Center | Community/Behavioral Health | 1801 Hickman Rd, Des Moines, IA 50314 | 2010-07-13 |
| 1265683718 | Broadlawns Medical Center | Nurse Practitioner | 1801 Hickman Rd, Des Moines, IA 50314-1505 | 2008-10-02 |
| 1962662379 | Broadlawns Medical Center | Psychologist | 1801 Hickman Rd, Des Moines, IA 50314-1505 | 2008-06-10 |
| 1013197060 | Broadlawns Medical Center | Pharmacy | 1801 Hickman Road, Des Moines, IA 50314 | 2007-11-07 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | BROADLAWNS MEDICAL CENTER FOUNDATION | Broadlawns Medical Center, 1801 Hickman Road, Des Moines, IA 50314 |
| Iowa Business Entities | BROADLAWNS MEDICAL CENTER GUILD | 1801 Hickman Road, Des Moines, IA 50314 |
| Street Address |
1801 HICKMAN ROAD |
| City | DES MOINES |
| State | IA |
| Zip Code | 50314-1548 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457357642 | Roy Alden Hart | Specialist | 1801 Hickman Road, Broadlawns Medical Center, Des Moines, IA 50314 | 2005-06-22 |
| 1932668639 | Rochean Cofield | Social Worker | 1801 Hickman Road, Des Moines, IA 50314-1597 | 2019-03-13 |
| 1487183893 | Alyssa Kate Plouzek | Radiology | 1801 Hickman Road, Des Moines, IA 50314 | 2017-06-08 |
| 1578092839 | Daniel Agraz | Ophthalmology | 1801 Hickman Road, Des Moines, IA 50314 | 2017-06-08 |
| 1801131461 | Meredith Dallas Olson | Nurse Practitioner | 1801 Hickman Road, Des Moines, IA 50314-1597 | 2012-12-06 |
| 1962706168 | Joyce Mischel | Family Medicine | 1801 Hickman Road, Des Moines, IA 50314-1975 | 2011-01-03 |
| 1245466424 | Megan M Norris | Pediatrics | 1801 Hickman Road, Des Moines, IA 50314-1597 | 2009-06-02 |
| 1245495027 | Juliet Anne Bles | Social Worker | 1801 Hickman Road, Broadlawns Medical Center, Des Moines, IA 50314 | 2008-07-22 |
| 1013197060 | Broadlawns Medical Center | Pharmacy | 1801 Hickman Road, Des Moines, IA 50314 | 2007-11-07 |
| 1306068754 | Broadlawns Medical Center | Anesthesiology | 1801 Hickman Road, Des Moines, IA 50314-1548 | 2007-05-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982266979 | Dental Connections, Inc. | Dentist | 1111 9th Street, Suite 190, Des Moines, IA 50314 | 2019-07-01 |
| 1760910723 | Kelsey Taylor | Social Worker | 1761 Hickman Rd, Des Moines, IA 50314 | 2017-06-02 |
| 1184085672 | Allison J Robbins | Counselor | 1063 14th Place, Suite A, Des Moines, IA 50314 | 2016-03-11 |
| 1083081715 | Taylor Witzel | Specialist/Technologist | 450 Laurel Street, Des Moines, IA 50314 | 2015-08-28 |
| 1376893933 | Caring Hearts LLC | In Home Supportive Care | 1620 Pleasant, #245, Des Moines, IA 50314 | 2012-09-11 |
| 1104117522 | Akinbode Solomon Egbelakin | Pediatrics | 1111 6th Ave # Main3, Des Moines, IA 50314 | 2011-04-20 |
| 1447488325 | Abdelaziz Elhaddad | Internal Medicine | 95 University Avenue, Suite 1, Des Moines, IA 50314 | 2009-06-30 |
| 1356584080 | Tara Michelle Graff | Internal Medicine | 411 Laurel Street Suite A300, Des Moines, IA 50314 | 2009-04-10 |
| 1700068517 | Planned Parenthood of The Heartland | Family Medicine | 123 Clark Street, Des Moines, IA 50314 | 2007-12-04 |
| 1790903235 | Christy J. Meyer | Counselor | 1063 14th Place, Suite A, Des Moines, IA 50314 | 2007-04-22 |
| Find all providers in zip 50314 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992795496 | Paul Henry Novak | Emergency Medicine | 6079 Ne 9th St, Des Moines, IA 50313-1531 | 2005-10-26 |
| 1407203037 | Todd Sexton | Emergency Medicine | 700 E University Ave, Des Moines, IA 50316-2302 | 2016-05-24 |
| 1043679699 | Chad William Becker | Emergency Medicine | 1200 Pleasant St, Des Moines, IA 50309-1406 | 2016-02-10 |
| 1720472442 | Des Moines River Physicians, LLC | Emergency Medicine | 1111 6th Ave, Des Moines, IA 50314-2613 | 2015-03-19 |
| 1093114472 | Alyssa Drezdon | Emergency Medicine | 1200 Pleasant St, Des Moines, IA 50309-1406 | 2014-08-21 |
| 1356756175 | Erik Adair | Emergency Medicine | 1200 Pleasant St, Des Moines, IA 50309-1453 | 2014-07-01 |
| 1962841338 | Karin Howe | Emergency Medicine | 1111 6th Ave, Des Moines, IA 50314-2613 | 2013-06-19 |
| 1750728309 | Luke Lowry | Emergency Medicine | 1200 Pleasant St, Des Moines, IA 50309-1406 | 2013-05-22 |
| 1912340076 | Brittany D Jensen | Emergency Medicine | 1200 Pleasant St, Des Moines, IA 50309-1406 | 2013-04-09 |
| 1346683539 | Chase Nicholas Deobald | Emergency Medicine | 1200 Pleasant St, Des Moines, IA 50309-1406 | 2013-04-08 |
| Find all providers in DES MOINES | ||||
| City | DES MOINES |
| Zip Code | 50314 |
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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.