CAPITAL ORTHOPAEDICS AND SPORTS MEDICINE PC (NPI# 1932432457) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932432457 |
| Entity Type | Organization |
| Organization Name | CAPITAL ORTHOPAEDICS AND SPORTS MEDICINE PC |
| Practice Address |
12499 University Ave Suite 210 Clive IA 50325-8281 |
| Practice Telephone | 5154402676 |
| Practice Fax Number | 5154402677 |
| Mailing Telephone | 5154402676 |
| Mailing Fax Number | 5154402677 |
| Enumeration Date | 2009-09-16 |
| Last Update Date | 2013-01-22 |
| Authorized Official Name | DR. WILLIAM CHARLES JACOBSON (SHAREHOLDER) |
| Authorized Official Telephone | 5154402676 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
26239 | IA | Allopathic & Osteopathic Physicians |
| N | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
19337 | IA | Allopathic & Osteopathic Physicians |
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
33389 | IA | Allopathic & Osteopathic Physicians |
| N | 208100000X | Physical Medicine & Rehabilitation | 27587 | IA | Allopathic & Osteopathic Physicians |
| N | 2086S0105X |
Surgery Specialization: Surgery of the Hand |
37744 | IA | Allopathic & Osteopathic Physicians |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
00693 | IA | Podiatric Medicine & Surgery Service Providers |
| Y | 207X00000X | Orthopaedic Surgery | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 1932432457 | 05 |
| Street Address |
12499 UNIVERSITY AVE SUITE 210 |
| City | CLIVE |
| State | IA |
| Zip Code | 50325-8281 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033561295 | Paula Elizabeth Stageman | Nurse Practitioner | 12499 University Ave, Suite 280, Clive, IA 50325-8288 | 2016-07-11 |
| 1699177360 | Trisha Hittenmiller | Nurse Practitioner | 12499 University Ave, Ste 200, Clive, IA 50325-8281 | 2014-09-24 |
| 1275886053 | Beth Joann Macpherson | Audiologist | 12499 University Ave, Suite 200, Clive, IA 50325-8288 | 2012-10-18 |
| 1407085103 | Todd Charles Peterson | Orthopaedic Surgery | 12499 University Ave, Clive, IA 50325-8288 | 2009-07-02 |
| 1780818138 | Iowa Ear Center | Specialist | 12499 University Ave, Suite 200, Clive, IA 50325-8288 | 2009-05-13 |
| 1669669628 | Matthew D Danilson | Physician Assistant | 12499 University Ave, Suite 210, Clive, IA 50325-8281 | 2007-10-03 |
| 1861614646 | Matthew J Carfrae | Otolaryngology | 12499 University Ave, Ste 200, Clive, IA 50325-8281 | 2007-05-03 |
| 1962547356 | Jill A Frerichs | Podiatrist | 12499 University Ave, Suite 210, Clive, IA 50325-8288 | 2007-02-21 |
| 1497809859 | Gregory J Yanish | Surgery | 12499 University Ave, Ste. 210, Clive, IA 50325-8288 | 2007-01-23 |
| 1134277429 | Sarah M Fugleberg | Audiologist | 12499 University Ave, Ste 200, Clive, IA 50325-8281 | 2007-01-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| 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 Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558317305 | Metro Orthopaedic Surgery, P.C. | Orthopaedic Surgery | 13375 University Ave, Clive, IA 50325-8261 | 2006-05-25 |
| 1407085103 | Todd Charles Peterson | Orthopaedic Surgery | 12499 University Ave, Clive, IA 50325-8288 | 2009-07-02 |
| 1235155847 | Brian M Crites | Orthopaedic Surgery | 12499 University Ave, Suite 210, Clive, IA 50325-8281 | 2006-07-15 |
| 1548212368 | Mark Douglas Fish | Orthopaedic Surgery | 12499 University Ave, Ste. 210, Clive, IA 50325-8288 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740660802 | Mercy Medical Center - Newton | Orthopaedic Surgery | 300 N 4th Ave E Ste C, Newton, IA 50208-3155 | 2015-06-04 |
| 1891057550 | Cnos, PC | Orthopaedic Surgery | 2735 Outer Drive N, Sioux City, IA 51104-1590 | 2012-06-08 |
| 1568730323 | Jonathan D Winston | Orthopaedic Surgery | 2300 53rd Ave Ste 100, Bettendorf, IA 52722-7565 | 2011-12-08 |
| 1770874034 | Megan Crosmer | Orthopaedic Surgery | 3385 Dexter Ct Ste 300, Davenport, IA 52807-3471 | 2011-04-21 |
| 1457672719 | Paul Butler | Orthopaedic Surgery | 350 Ne 36th St Ste 213, Ankeny, IA 50021-6728 | 2010-06-21 |
| 1164690574 | Md West One, PC | Orthopaedic Surgery | 201 Ridge St Ste 311, Council Bluffs, IA 51503-4643 | 2008-02-19 |
| 1487849527 | Joseph Albert Brunkhorst IIi | Orthopaedic Surgery | 350 Ne 36th St, Ankeny, IA 50021-6728 | 2007-09-12 |
| 1942409172 | David S. Tearse M.d., LLC | Orthopaedic Surgery | 112 14th St Se, Cedar Rapids, IA 52403-4025 | 2007-07-17 |
| 1134334006 | Jason Stanford | Orthopaedic Surgery | 516 Division St Ste 125, Cedar Falls, IA 50613-2380 | 2007-05-13 |
| 1982756284 | The Grinnell Institute for Bone Health | Orthopaedic Surgery | 810 Commercial St., Grinnell, IA 50112 | 2007-01-17 |
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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.