IOWA DERMATOLOGY CLINIC, PLC (NPI# 1083086862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083086862 |
| Entity Type | Organization |
| Organization Name | IOWA DERMATOLOGY CLINIC, PLC |
| Other Organization Name | RADIANT COMPLEXIONS DERMATOLOGY CLINIC |
| Practice Address |
3729 86th St Urbandale IA 50322 |
| Mailing Address |
6800 Lake Dr Ste 285 West Des Moines IA 50266-2544 |
| Practice Telephone | 5152772813 |
| Practice Fax Number | 5152772814 |
| Mailing Telephone | 5152772813 |
| Mailing Fax Number | 5152772814 |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2018-07-11 |
| NPI Deactivation Date | 03/28/2018 |
| NPI Reactivation Date | 2018-06-27 |
| Authorized Official Name | DR. CHARLES LOVE (OWNER) |
| Authorized Official Telephone | 5152268484 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | IOWA DERMATOLOGY CLINIC, PLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Radiant Complexions Dermatology Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366916371 | Iowa Dermatology Clinic, Plc | Dermatology | 3720 N Ankeny Blvd Ste 101, Ankeny, IA 50023-4605 | 2019-01-14 |
| 1639541410 | Iowa Dermatology Clinic, Plc | Dermatology | 1510 Sw Oralabor Rd Ste C, Ankeny, IA 50023-7147 | 2015-10-20 |
| 1932571965 | Iowa Dermatology Clinic, Plc | Dermatology | 26 S 1st Ave, Suite 100, Marshalltown, IA 50158-5034 | 2015-10-29 |
| 1669844692 | Iowa Dermatology Clinic, Plc | Pathology | 6000 University Ave Ste 350, West Des Moines, IA 50266-8219 | 2015-10-29 |
| 1508238395 | Iowa Dermatology Clinic, Plc | Dermatology | 5921 Se 14th St, Suite 2500, Des Moines, IA 50320-1746 | 2015-10-20 |
| 1487026266 | Iowa Dermatology Clinic, Plc | Dermatology | 2010 Philadelphia St, Suite 1, Ames, IA 50010-8784 | 2015-10-20 |
| Street Address |
3729 86TH ST |
| City | URBANDALE |
| State | IA |
| Zip Code | 50322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598278434 | Mary Melissa Buchanan | Hospice Care, Community Based | 6101 Goodman Dr, Urbandale, IA 50322 | 2017-11-14 |
| 1932629110 | Kelsey Coaldrake | Speech-Language Pathologist | 2570 106th St Ste E, Urbandale, IA 50322 | 2017-06-20 |
| 1861940207 | Jessalynn Bradley | Home Health Aide | 8704 Meredith Dr., Apt. 208, Urbandale, IA 50322 | 2016-09-14 |
| 1598134686 | Iowa Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 14201 Hickman Rd., Urbandale, IA 50322 | 2015-09-18 |
| 1114303484 | Monique I Elgersma | Marriage & Family Therapist | 3829 71st St Ste A, Urbandale, IA 50322 | 2015-08-10 |
| 1821437922 | Maggie Lynn Leavens | Physical Therapy Assistant | 4614 84th Street, Urbandale, IA 50322 | 2013-06-21 |
| 1225378581 | Nicholas David Burton Lantz | Physical Therapy Assistant | 4614 Nw 84th Street, Urbandale, IA 50322 | 2013-02-25 |
| 1750645826 | Joseph Horn Thompson | Pharmacist | 9616 Quail Ridge, Urbandale, IA 50322 | 2012-07-03 |
| 1437481827 | Community Support Advocates, LLC | Social Worker | 6000 Aurora Avenue, Suite B, Des Moines, IA 50322 | 2010-02-10 |
| 1174765002 | Roxi J Evans-guilloz | Physical Therapist | 9005 Oakwood Dr, Urbandale, IA 50322 | 2009-03-24 |
| Find all providers in zip 50322 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730188160 | Greater Des Moines Dermatology PC | Dermatology | 2424 128th St, Nw 128th Street, Urbandale, IA 50323-1816 | 2005-07-18 |
| 1861022568 | Jacob Anthony Lorsung | Dermatology | 2424 128th St, Urbandale, IA 50323-1816 | 2020-01-22 |
| 1245239623 | Timothy Garth Abrahamson | Dermatology | 2424 128th St, Nw 128th Street, Urbandale, IA 50323-1816 | 2005-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730705385 | Iowa Dermatology Consultants, Pllc | Dermatology | 974 73rd St Unit 39&40, West Des Moines, IA 50265-1024 | 2020-06-19 |
| 1558909572 | Iowa Dermatology Clinic Plc | Dermatology | 1895 Se Grimes Blvd., Ste. 103, Grimes, IA 50111-1277 | 2019-12-20 |
| 1134781842 | Iowa Dermatology Clinic Plc | Dermatology | 311 S Clark St Ste 280, Carroll, IA 51401-3086 | 2019-07-02 |
| 1366916371 | Iowa Dermatology Clinic, Plc | Dermatology | 3720 N Ankeny Blvd Ste 101, Ankeny, IA 50023-4605 | 2019-01-14 |
| 1972023414 | Iowa Dermatology Clinic Plc | Dermatology | 9500 University Ave Ste 1114, West Des Moines, IA 50266-1745 | 2017-06-26 |
| 1275998692 | Skinspa LLC | Dermatology | 9350 University Ave Ste 132, West Des Moines, IA 50266-1648 | 2015-12-30 |
| 1639541410 | Iowa Dermatology Clinic, Plc | Dermatology | 1510 Sw Oralabor Rd Ste C, Ankeny, IA 50023-7147 | 2015-10-20 |
| 1760870851 | Forefront Dermatology, S.c. | Dermatology | 202 10th Street, Sw, Suite 290, Cedar Rapids, IA 52403 | 2014-12-26 |
| 1982942702 | Iowa Dermatology Clinic Plc | Dermatology | 26 S 1st Ave, Suite 100, Marshalltown, IA 50158-5032 | 2013-01-29 |
| 1548532864 | Mid-iowa Dermatology, P. L. L. C. | Dermatology | 11 N 14th St, Fort Dodge, IA 50501-4241 | 2012-02-01 |
| Find all providers with the same taxonomy | ||||
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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.