STADIA SPORTS MEDICINE PC (NPI# 1962453274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962453274 |
| Entity Type | Organization |
| Organization Name | STADIA SPORTS MEDICINE PC |
| Practice Address |
6000 University Ave Suite 250 West Des Moines IA 50266-8203 |
| Mailing Address |
6000 University Ave Suite 250 West Des Moines IA 50266 |
| Practice Telephone | 5152211102 |
| Practice Fax Number | 5152211272 |
| Mailing Telephone | 5152211102 |
| Mailing Fax Number | 5152211272 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2017-08-16 |
| Authorized Official Name | DR. CHAD THOMAS CARLSON (CEO, STADIA SPORTS MEDICINE) |
| Authorized Official Telephone | 5152211102 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 204C00000X | Neuromusculoskeletal Medicine, Sports Medicine | 36501 | IA | Allopathic & Osteopathic Physicians |
| Street Address |
6000 UNIVERSITY AVE SUITE 250 |
| City | WEST DES MOINES |
| State | IA |
| Zip Code | 50266-8203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376548784 | Daniel P. Allen | Internal Medicine | 6000 University Ave, Suite 300, West Des Moines, IA 50266-8203 | 2005-06-14 |
| 1770093106 | Elizabeth Jordan Hamer | Physician Assistant | 6000 University Ave, Suite 450, West Des Moines, IA 50266 | 2017-10-12 |
| 1467907394 | Cynthia Ann Coenen | Nurse Practitioner | 6000 University Ave, Suite 200, West Des Moines, IA 50266 | 2016-08-21 |
| 1568916237 | Unitypoint Health-dm | General Acute Care Hospital | 6000 University Ave, Suite 124, West Des Moines, IA 50266-8203 | 2016-08-10 |
| 1891185013 | Amanda Sue Gerst | Audiologist | 6000 University Ave, Suite 230, West Des Moines, IA 50266-8203 | 2015-01-26 |
| 1952719171 | Jordan Dielmann | Specialist/Technologist | 6000 University Ave, Suite 250, West Des Moines, IA 50266-8203 | 2014-07-31 |
| 1821406356 | Ana Valencia | Nurse Practitioner | 6000 University Ave, Suite 200, West Des Moines, IA 50266-8203 | 2014-07-29 |
| 1700201407 | Dennis P Porto Md PC | Otolaryngology | 6000 University Ave, Suite 230, West Des Moines, IA 50266-8203 | 2014-03-04 |
| 1770925935 | Cindy S Pontious | Nurse Practitioner | 6000 University Ave, Suite 200, West Des Moines, IA 50266 | 2013-07-29 |
| 1053755835 | Peggy Jo Wasser Scott | Physical Therapist | 6000 University Ave, Suite 203, West Des Moines, IA 50266-8203 | 2013-04-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013544667 | Annie Penquite | Physician Assistant | 6001 Westown Pwky, West Des Moines, IA 50266 | 2020-03-24 |
| 1730733205 | Erin Allyn Fiala | Counselor | 1200 Valley West Dr Suite 508, West Des Moines, IA 50266 | 2019-08-01 |
| 1598325151 | Cornerstone Pediatrics and Family Allergy, Plc | Pediatrics | 6800 Lake Drive, #260, West Des Monies, IA 50266 | 2019-06-17 |
| 1093286395 | Ccrc of West Des Moines, LLC | Skilled Nursing Facility | 8950 Coachlight Drive, West Des Moines, IA 50266 | 2018-12-12 |
| 1326517400 | Merit Hearing LLC | Audiologist-Hearing Aid Fitter | 2910 Westown Pkwy Ste 110, West Des Moines, IA 50266 | 2018-11-18 |
| 1699253807 | Diamond Home Health Care Services | Home Health | 4949 Weston Pkwy Ste 165 #836, West Des Moines, IA 50266 | 2018-07-31 |
| 1285129932 | Hy Vee Inc | Pharmacy | 375 South Jordan Creek Parkway, West Des Moines, IA 50266 | 2018-06-26 |
| 1669965208 | Rx Precision, Inc. | Case Management | 6205 Mills Civic Pkwy Ste 201, West Des Moines, IA 50266 | 2018-06-08 |
| 1912406588 | Cora Schuhmacher, Psy.d., Pllc | Psychologist | 1045 76th St Unit 3030, West Des Moines, IA 50266 | 2018-02-08 |
| 1508374778 | Brian L Bentley | Counselor | 5500 Wild Rose Lane, Suite 400, West Des Moines, IA 50266 | 2018-01-22 |
| Find all providers in zip 50266 | ||||
| Taxonomy Code | 204C00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neuromusculoskeletal Medicine, Sports Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326008368 | Chad Thomas Carlson | Neuromusculoskeletal Medicine, Sports Medicine | 6000 University Ave, Suite 250, West Des Moines, IA 50266-8203 | 2006-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629116629 | David Timothy Berg | Neuromusculoskeletal Medicine, Sports Medicine | 3600 30th St, Des Moines, IA 50310-5753 | 2007-02-02 |
| City | WEST DES MOINES |
| Zip Code | 50266 |
Please comment or provide details below to improve the information on STADIA SPORTS MEDICINE PC.
| 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.