COUNTRY CLINIC MEDICAL SERVICES INC (NPI# 1396890158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396890158 |
| Entity Type | Organization |
| Organization Name | COUNTRY CLINIC MEDICAL SERVICES INC |
| Other Organization Name | COUNTRY CLINIC |
| Practice Address |
120 Ne Dartmoor Dr Waukee IA 50263-9660 |
| Mailing Address |
120 Ne Dartmoor Dr Po Box 968 Waukee IA 50263-9660 |
| Practice Telephone | 5159873117 |
| Practice Fax Number | 5159873119 |
| Mailing Telephone | 5159873117 |
| Mailing Fax Number | 5159873119 |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. KIM K COUNTRYMAN (OWNER) |
| Authorized Official Telephone | 5159873117 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 02312 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0284083 | 05 | |
| IA | 1043646 | 05 |
| Other Name | Type Code |
|---|---|
| Country Clinic | Doing Business As Name - Organization |
| Street Address |
120 NE DARTMOOR DR |
| City | WAUKEE |
| State | IA |
| Zip Code | 50263-9660 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750382347 | Kim K Countryman | Family Medicine | 120 Ne Dartmoor Dr, Waukee, IA 50263 | 2005-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427618032 | Blake Michael Louscher | Dentist | 2505 Se Encompass Drive, Waukee, IA 50263 | 2019-06-17 |
| 1407377344 | Fusion Foot and Ankle, LLC | Podiatrist | 110 Us Hwy 6 Suite 80, Waukee, IA 50263 | 2017-06-30 |
| 1912317645 | Jennifer Brezina | Counselor | 14225 University Ave Ste 120, Waukee, IA 50263 | 2014-05-02 |
| 1356782668 | Hy Vee Inc | Pharmacy | 1005 East Hickman, Waukee, IA 50263 | 2013-07-15 |
| 1639414741 | Erin Good | Dietitian, Registered | 1005 East Hickman Road, Waukee, IA 50263 | 2012-11-29 |
| 1407138084 | Advantages In Life Inc | In Home Supportive Care | 670 Elm, Waukee, IA 50263 | 2011-09-09 |
| 1669601951 | Deepika Verma | Dentist | 115 Se Telby Ln, Waukee, IA 50263 | 2009-07-07 |
| 1205046778 | Lori Walton | Speech-Language Pathologist | 31805 Silverado Lane, Waukee, IA 50263 | 2007-05-23 |
| 1891915245 | Signature Properties of Waukee, LLC | Skilled Nursing Facility | 1645 Se Holiday Crest Circle, Waukee, IA 50263 | 2007-04-26 |
| 1598818981 | Oswald Family Chiropractic PC | Chiropractor | 450 Se University Ave, Waukee, IA 50263 | 2007-01-19 |
| Find all providers in zip 50263 | ||||
| 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 |
|---|---|---|---|---|
| 1356756266 | Christine Schaplowsky Davis | Family Medicine | 155 Bel Aire Dr, Waukee, IA 50263-9771 | 2014-06-30 |
| 1225297757 | Brianne Nicole Day | Family Medicine | 25 W Hickman Road, Waukee, IA 50263-5018 | 2008-06-09 |
| 1760680235 | Jenna Kemp | Family Medicine | 30 E Hickman Rd, Waukee, IA 50263-5011 | 2007-07-06 |
| 1508844309 | John J Hembry | Family Medicine | 30 E Highway 6, Waukee, IA 50263-5011 | 2006-01-03 |
| 1750382347 | Kim K Countryman | Family Medicine | 120 Ne Dartmoor Dr, Waukee, IA 50263 | 2005-08-03 |
| 1811378086 | April Nicole Kolb | Family Medicine | 842 Ne Alices Rd, Waukee, IA 50263-8857 | 2015-06-14 |
| 1851738926 | Brandon Louis Lee May | Family Medicine | 30 E Hickman Rd, Waukee, IA 50263-5011 | 2013-05-30 |
| 1023321585 | Johanna Engel-brower | Family Medicine | 30 E Hickman Rd, Waukee, IA 50263-5011 | 2010-07-26 |
| 1013229236 | William H Schupp | Family Medicine | 842 Ne Alices Rd, Waukee, IA 50263-8857 | 2010-07-02 |
| 1114238995 | Mercy Clinics, Inc | Family Medicine | 25 W Hickman Road, Waukee, IA 50263-5018 | 2010-06-28 |
| Find all providers in WAUKEE | ||||
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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.