MR. DOUGLAS EDWIN HENRICH (NPI# 1588634414) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588634414 |
| Entity Type | Individual |
| Full Name | MR. DOUGLAS EDWIN HENRICH |
| Credential | M.D. |
| Practice Address |
1225 S Gear Ave Ste 255 West Burlington IA 52655-1687 |
| Practice Telephone | 3197522725 |
| Practice Fax Number | 3197531084 |
| Mailing Telephone | 3197522725 |
| Mailing Fax Number | 3197531084 |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2015-02-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207K00000X | Allergy & Immunology | 31549 | IA | Allopathic & Osteopathic Physicians |
| N | 207KA0200X |
Allergy & Immunology Specialization: Allergy |
31549 | IA | Allopathic & Osteopathic Physicians |
| N | 207KI0005X |
Allergy & Immunology Specialization: Clinical & Laboratory Immunology |
31549 | IA | Allopathic & Osteopathic Physicians |
| Y | 207Y00000X | Otolaryngology | 31549 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0151092 | 05 | |
| IA | WELLMARK # | 58619 | 01 |
| Street Address |
1225 S GEAR AVE STE 255 |
| City | WEST BURLINGTON |
| State | IA |
| Zip Code | 52655-1687 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932101466 | Theron Jameson | Specialist | 1225 S Gear Ave, Ste 159, West Burlington, IA 52655 | 2005-08-15 |
| 1750900809 | Logan Taylor Chiri | Nurse Practitioner | 1225 S Gear Ave, West Burlington, IA 52655-1691 | 2020-04-09 |
| 1528627122 | Bailey Peterson | Social Worker | 1225 S Gear Ave, West Burlington, IA 52655-1691 | 2019-06-07 |
| 1992178099 | Anna Short | Social Worker | 1225 S Gear Ave, Mercy Plaza Ste 251, West Burlington, IA 52655-1691 | 2015-11-11 |
| 1013398023 | Lisa Ann Lake | Nurse Practitioner | 1225 S Gear Ave, Suite 159, West Burlington, IA 52655-1691 | 2015-06-16 |
| 1629464102 | Elisa Roth | Counselor | 1225 S Gear Ave, West Burlington, IA 52655-1691 | 2015-04-10 |
| 1851789135 | James Towlerton | Counselor | 1225 S Gear Ave, Mercy Plaza Suite 251, West Burlington, IA 52655-1691 | 2015-01-08 |
| 1578977138 | Charman Cole | Pharmacist | 1225 S Gear Ave, Suite 154, West Burlington, IA 52655-1691 | 2014-06-11 |
| 1659632768 | Audrey Eva Cook | Counselor | 1225 S Gear Ave, Mercy Plaza, Suite 251, West Burlington, IA 52655-1691 | 2012-06-05 |
| 1619237849 | John Thurman | Family Medicine | 1225 S Gear Ave, Suite Number 159, West Burlington, IA 52655-1691 | 2012-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679920045 | Breanne Vogel | Nurse Practitioner | 1225 South Gear Avenue, Suite 159, Great River Family Practice Clinic, West Burlington, IA 52655 | 2016-05-16 |
| 1639538010 | Kala Haisch | Nurse Practitioner | 1225 S. Gear Ave., Mercy Plaza, Suite 251, West Burlington, IA 52655 | 2016-02-15 |
| 1326305830 | Ryan Deets | Surgery | 1223 S Gear Ave Ste 202, West Burlington, IA 52655 | 2012-04-20 |
| 1912100173 | Jennifer Yancey | Dietitian, Registered | Great River Medical Center Center for Rehabilitation, 1401 W. Agency Rd., West Burlington, IA 52655 | 2007-06-06 |
| 1043348196 | Wilson Hearing Aids & Services Inc | Hearing Instrument Specialist | 313 E Agency Rd, West Burlington, IA 52655 | 2007-03-01 |
| 1730286204 | Eric A Hanks | Chiropractor | 433 E Mt Pleasant St, West Burlington, IA 52655 | 2006-09-19 |
| 1093825176 | Michael Steven Mathews | Dentist | 409 Layne Dr, West Burlington, IA 52655 | 2006-08-30 |
| 1952383259 | Craig Huston | Emergency Medical Technician, Basic | 1221d S Gear Ave, West Burlington, IA 52655 | 2005-11-14 |
| 1255339750 | Community Health Centers of Southeastern Iowa Inc | Internal Medicine | 1706 West Agency Road, West Burlington, IA 52655 | 2005-07-08 |
| 1730798570 | Burlington Oral Surgery | Dentist | 1225 S. Gear Ave., Mercy Plaza Ste 156, West Burlington, IA 52655 | 2020-07-28 |
| Find all providers in zip 52655 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326157140 | Burlington Ear Nose & Throat Clinic PC | Otolaryngology | 1225 S Gear Ave, Ste 255, West Burlington, IA 52655-1687 | 2006-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134658552 | Kristen Leigh Seligman | Otolaryngology | 200 Hawkins Dr, Dept of Otolaryngology, Iowa City, IA 52242-1009 | 2017-06-08 |
| 1316389653 | Koch Facial Plastic Surgery PC | Otolaryngology | 4855 Mills Civic Parkway #100, West Des Moines, IA 50265 | 2013-07-29 |
| 1770835563 | Charles Douglas Jons | Otolaryngology | 2916 Forest Hills Dr, Ames, IA 50014-3583 | 2012-10-04 |
| 1457606584 | Lindsay Jo Sturm | Otolaryngology | 2122 Leopold Dr, Ames, IA 50010-4499 | 2012-07-15 |
| 1992099402 | Stephanie Lanae Burger | Otolaryngology | 2730 Pierce St Ste 204, Sioux City, IA 51104-3764 | 2011-06-01 |
| 1245380237 | Michael Crawford | Otolaryngology | 320 Mckenzie Ave Ste 202, Council Bluffs, IA 51503-1002 | 2007-01-11 |
| 1356451421 | Kurtis David Korver | Otolaryngology | 700 Juneau Ave Se, Orange City, IA 51041 | 2006-08-30 |
| 1184682189 | Douglas R Hoisington | Otolaryngology | 2600 Westown Pkwy Ste 360, West Des Moines, IA 50266-7306 | 2006-05-02 |
| 1205893781 | Gordon Ray Johnson | Otolaryngology | 3906 Lillie Ave., Suite 1, Davenport, IA 52806-4432 | 2006-04-27 |
| 1548241037 | Craig Charles Herther | Otolaryngology | 310 N Grandview Ave, Dubuque, IA 52001-6388 | 2005-11-10 |
| Find all providers with the same taxonomy | ||||
| City | WEST BURLINGTON |
| Zip Code | 52655 |
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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.