DOUGLAS K HENSTROM (NPI# 1558333179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558333179 |
| Entity Type | Individual |
| Full Name | DOUGLAS K HENSTROM |
| Credential | M.D. |
| Practice Address |
200 Hawkins Dr Iowa City IA 52242-1007 |
| Mailing Address |
2255 N 1700 W Ste 200 Layton UT 84041-1187 |
| Practice Telephone | 3193563600 |
| Practice Fax Number | 3193564547 |
| Mailing Telephone | 8017762220 |
| Mailing Fax Number | 8018202772 |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2017-04-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Y00000X | Otolaryngology | 39672 | IA | Allopathic & Osteopathic Physicians |
| N | 207Y00000X | Otolaryngology | 47669 | MN | Allopathic & Osteopathic Physicians |
| N | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
39672 | IA | Allopathic & Osteopathic Physicians |
| Y | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
10222796-1205 | UT | Allopathic & Osteopathic Physicians |
| N | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
39672 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 767689100 | 05 |
| Street Address |
200 HAWKINS DR |
| City | IOWA CITY |
| State | IA |
| Zip Code | 52242-1007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164425963 | Matthew T Spragg | Emergency Medicine | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2005-05-24 |
| 1205437951 | Jennifer Renee Manternach | Nurse Practitioner | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-11-07 |
| 1144821794 | Jannet S Eastman | Nurse Practitioner | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-11-02 |
| 1043810245 | Abbey Lorraine Foglesong | Dietitian, Registered | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-10-27 |
| 1972101533 | Lindy Pelzer | Nurse Practitioner | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-10-15 |
| 1124626437 | Georgianne Younger | Genetic Counselor, MS | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-10-09 |
| 1114534237 | Bharatendu Chandra | Medical Genetics | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-09-24 |
| 1023625142 | Moon Ley Tung | Medical Genetics | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-09-24 |
| 1225645187 | Sinan Akay | Radiology | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-09-24 |
| 1376158170 | Aygun Asgarli | Psychiatry & Neurology | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-09-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033738679 | Shannon Louise Miers | Physical Therapist | Ui Sports Medicine (iosmr), 2701 Prairie Meadow Drive, Iowa City, IA 52242 | 2020-04-14 |
| 1821624230 | Victoria Troesch | Student in an Organized Health Care Education/Training Program | 375 Newton Rd, Iowa City, IA 52242 | 2020-03-17 |
| 1891338539 | Kira Ann Hennes Blum | Dietitian, Registered | 930 Evashevski Dr., Jacobson Building, Iowa City, IA 52242 | 2019-10-25 |
| 1407330483 | Kristin L Heider | Psychologist | 616 E Bloomington Street, Iowa City, IA 52242 | 2018-09-17 |
| 1447738398 | Allison Kral | Dietitian, Registered | 200 Hawkins Dr. W146 Gh, Iowa City, IA 52242 | 2018-08-02 |
| 1528544780 | Abigail Lynne Schiltz | Physician Assistant | 200 Hawkins Dr 01290a Pfp, Iowa City, IA 52242 | 2018-07-11 |
| 1710474259 | Bashar H. H. Abuqayas | Hospitalist | 200 Hawkins Dr, Se 636 Gh, Uihc-internal Medicine, Iowa City, IA 52242 | 2018-04-19 |
| 1023547395 | Tyler Quist | Internal Medicine | 200 Hawkins Dr Dept of Ophthalmology, Iowa City, IA 52242 | 2017-06-08 |
| 1972962371 | Angeleah Korin Whitlatch | Social Worker | 100 Hawking Drive, Iowa City, IA 52242 | 2016-02-15 |
| 1649667734 | Jennie Sertterh | Specialist/Technologist | 1 Elliot Drive, S181 Carver Hawkeye Arena, Iowa City, IA 52242 | 2015-04-16 |
| Find all providers in zip 52242 | ||||
| Taxonomy Code | 207YX0007X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Plastic Surgery within the Head & Neck |
| An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy is currently provided in the subspecialty of Otolaryngology/Facial Plastic Surgery (see Taxonomy Code 207YX0905X) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427045798 | Dean P Lyons | Otolaryngology | 1223 S Gear Ave, Eastman Plaza Suite 308, West Burlington, IA 52655-1694 | 2005-10-03 |
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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.