HEARTLAND DERMATOLGY & SKIN CANCER CENTER PC (NPI# 1891862033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891862033 |
| Entity Type | Organization |
| Organization Name | HEARTLAND DERMATOLGY & SKIN CANCER CENTER PC |
| Practice Address |
12327 Stratford Dr Clive IA 50325-8148 |
| Practice Telephone | 5152247088 |
| Practice Fax Number | 5152249228 |
| Mailing Telephone | 5152247088 |
| Mailing Fax Number | 5152249228 |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2007-12-07 |
| Authorized Official Name | DR. AVA RISA FELDMAN (CO-OWNER) |
| Authorized Official Telephone | 5152247088 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0900X |
Dermatology Specialization: Dermatopathology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | MEDICARE RAILROAD | CN3179 | 01 |
| Street Address |
12327 STRATFORD DR |
| City | CLIVE |
| State | IA |
| Zip Code | 50325-8148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891792958 | Ava Risa Feldman | Dermatology | 12327 Stratford Dr, Clive, IA 50325-8148 | 2005-07-05 |
| 1477076628 | Forefront Dermatology, S.c. | Dermatology | 12327 Stratford Dr, Clive, IA 50325 | 2017-07-19 |
| 1487106084 | Jenny Myers | Nurse Practitioner | 12327 Stratford Dr, Clive, IA 50325-8148 | 2016-10-29 |
| 1447600945 | Imge Hulur | Dermatology | 12327 Stratford Dr, Clive, IA 50325-8148 | 2016-06-15 |
| 1235554163 | Jacquelyn Nichole Swim | Nurse Practitioner | 12327 Stratford Dr, Clive, IA 50325-8148 | 2014-03-01 |
| 1669786273 | Seth R Robb | Physician Assistant | 12327 Stratford Dr, Clive, IA 50325-8148 | 2010-08-06 |
| 1154479764 | Rachel R Ford | Physician Assistant | 12327 Stratford Dr, Clive, IA 50325-8148 | 2007-01-08 |
| 1023087426 | Kelly Marie Thomason | Physician Assistant | 12327 Stratford Dr, Clive, IA 50325-8148 | 2006-03-16 |
| 1053310656 | Gloria J Thielking | Physician Assistant | 12327 Stratford Dr, Clive, IA 50325-8148 | 2005-07-18 |
| 1841298858 | Marie Emma Kresse | Physician Assistant | 12327 Stratford Dr, Clive, IA 50325-8148 | 2005-07-13 |
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|---|---|---|---|---|
| 1104449446 | Clive Behavioral Health LLC | Psychiatric Hospital | 1500 Nw 114th St, Clive, IA 50325 | 2020-05-21 |
| 1609426519 | Caroline Silva Pereira Lara Ribeiro | Occupational Therapist | 15500 Boston Parkway, Appt 110, Clive, IA 50325 | 2019-09-13 |
| 1487203873 | Karen Turnure | Technician | 4524 Nw 16th St, Clive, IA 50325 | 2019-09-09 |
| 1659920320 | Phs Walnut Ridge LLC | Skilled Nursing Facility | 1703 Campus Drive, Clive, IA 50325 | 2019-09-05 |
| 1700288834 | Lindsey White | Chiropractor | 12931 University Ave, Suite 103, Clive, IA 50325 | 2014-09-19 |
| 1811337389 | Metro West Learning Center, LLC | Counselor | 13300 Hickman Rd Ste 110, Clive, IA 50325 | 2013-06-28 |
| 1700110343 | Rodolfo Mallorca Legislador Sr. | Family Medicine | 1665 Nw 97th St., Clive, IA 50325 | 2009-09-30 |
| 1891961900 | Erin Ducharme | Dermatology | 16349 Sheridan Drive, Suite 101, Clive, IA 50325 | 2008-05-08 |
| 1174792873 | The Iowa Clinic PC | Prosthetic/Orthotic Supplier | 12655 University Ave, Ste 160, Clive, IA 50325 | 2008-02-27 |
| 1164623393 | Melisa Coaker | Internal Medicine | 1275 Nw 128th St, Ste 200, Clive, IA 50325 | 2007-05-28 |
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| Taxonomy Code | 207ND0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Dermatopathology |
| A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. |
| 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 Dermatology, 2007. http://www.abderm.org/; American Osteopathic Board of Dermatology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Dermatology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922562743 | Central Iowa Dermatology LLC | Dermatology | 230 62nd Ct, West Des Moines, IA 50266-8602 | 2019-01-25 |
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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.