PHYSICIAN MANAGEMENT SERVICES OF IOWA, LLC (NPI# 1063051183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063051183 |
| Entity Type | Organization |
| Organization Name | PHYSICIAN MANAGEMENT SERVICES OF IOWA, LLC |
| Practice Address |
5501 Nw 86th St Ste 300 Johnston IA 50131-1810 |
| Mailing Address |
3113 Lawton Rd Ste 250 Orlando FL 32803-3517 |
| Practice Telephone | 8888298550 |
| Enumeration Date | 2020-01-06 |
| Last Update Date | 2020-01-06 |
| Authorized Official Name | BRETT KENEFICK (PRESIDENT) |
| Authorized Official Telephone | 8888298550 |
| Is Organization Subpart | Y |
| Parent Organization Name | VAXCARE CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326091935 | Physician Management Services of Iowa, LLC | Contractor | 315 Walnut St, Atlantic, IA 50022-1144 | 2006-05-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PHYSICIAN MANAGEMENT SERVICES OF IOWA, LLC. | 1089 Longfellow Dr Ste B, Hiawatha, IA 52233-2069 |
| Street Address |
5501 NW 86TH ST STE 300 |
| City | JOHNSTON |
| State | IA |
| Zip Code | 50131-1810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326575317 | Tyler Steven Olson | Family Medicine | 5501 Nw 86th St Ste 300, Johnston, IA 50131-1810 | 2017-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568011229 | Joseph Barnard | Technician | 6406 Theresa Dr, Johnston, IA 50131 | 2019-09-05 |
| 1073098208 | Heather Nicole Prettyman | Social Worker | 5406 Marle Hay Rd., Johnston, IA 50131 | 2018-10-03 |
| 1982182606 | Dental Studio of Iowa PC | Dentist | 5495 Nw 100th Street, Johnston, IA 50131 | 2018-08-03 |
| 1982063921 | Braincare, LLC | Physiological Laboratory | 6165 Nw 86th St Ste 130, Johnston, IA 50131 | 2016-02-18 |
| 1104293570 | Sarah Michelle Fees | Nurse Practitioner | 8605 Chambery Blvd, Johnston, IA 50131 | 2015-09-01 |
| 1013329978 | Jonathan Jeffrey Karch | Dentist | 5495 Nw 100th St, Johnston, IA 50131 | 2014-05-27 |
| 1053757500 | Patricia L Hart | Social Worker | 6061 Bradford Ln, Johnston, IA 50131 | 2013-05-10 |
| 1205105855 | Lesile Jane Mentele | Pharmacist | 6100 Nw 97th St, Johnston, IA 50131 | 2011-12-27 |
| 1750610812 | Amanda J Moore | Chiropractor | 8671 Northpark Ct, Johnston, IA 50131 | 2009-12-18 |
| 1225293426 | Center for Maximized Living, LLC | Chiropractor | 8671 Northpark Ct., Johnston, IA 50131 | 2008-07-28 |
| Find all providers in zip 50131 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326575317 | Tyler Steven Olson | Family Medicine | 5501 Nw 86th St Ste 300, Johnston, IA 50131-1810 | 2017-05-22 |
| 1134499742 | Thomas Charles Evans | Family Medicine | 7005 Nw Beaver Dr, Johnston, IA 50131-1249 | 2012-01-12 |
| 1467683227 | Constantine Vafidis | Family Medicine | 1524 Atwood Ave Ste 225, Johnston, RI 02919-3228 | 2009-07-28 |
| 1073738902 | Danny Paul Smith | Family Medicine | 7105 Nw 70th Ave, Johnston, IA 50131-1824 | 2007-04-16 |
| 1952423469 | Matthew John Byrnes | Family Medicine | 5800 S Winwood Dr, Johnston, IA 50131-1616 | 2007-04-04 |
| 1013963818 | Jason K Austin | Family Medicine | 1524 Atwood Ave Ste 220, Johnston, RI 02919-3278 | 2006-05-25 |
| 1700846474 | Mark Edward Jones | Family Medicine | 5900 Nw 86th St Ste 100, Johnston, IA 50131-2284 | 2006-03-25 |
| 1366425274 | Iowa Physicians Clinic Medical Foundation | Family Medicine | 8101 Birchwood Ct, Suite N, Johnston, IA 50131-2930 | 2005-11-23 |
| 1366433310 | Scott R Meyer | Family Medicine | 5900 Nw 86th St, Ste 100, Johnston, IA 50131-2284 | 2005-10-31 |
| 1417958489 | Robert A Lee | Family Medicine | 5501 Nw 86th St, Suite 300, Johnston, IA 50131 | 2005-08-02 |
| Find all providers in JOHNSTON | ||||
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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.