DR. CHARLES ALLEN DEPENA (NPI# 1568430171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568430171 |
| Entity Type | Individual |
| Full Name | DR. CHARLES ALLEN DEPENA |
| Credential | M.D. |
| Practice Address |
12368 Stratford Dr Suite 300 Clive IA 50325-8162 |
| Mailing Address |
4318 Oakwood Ln West Des Moines IA 50265-5423 |
| Practice Telephone | 5152269810 |
| Practice Fax Number | 5152268408 |
| Mailing Telephone | 5153279077 |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085N0700X |
Radiology Specialization: Neuroradiology |
34821 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 9268490 | 05 |
| Street Address |
12368 STRATFORD DR SUITE 300 |
| City | CLIVE |
| State | IA |
| Zip Code | 50325-8162 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003895962 | James H Jacobs Jr. | Radiology | 12368 Stratford Dr, Suite 300, Clive, IA 50325-8162 | 2006-01-10 |
| 1609008515 | Rory Ryan Karibo | Radiology | 12368 Stratford Dr, Suite 300, Clive, IA 50325-8162 | 2009-08-12 |
| 1225279136 | Richard Ryan Menzel | Radiology | 12368 Stratford Dr, Suite 300, Clive, IA 50325-8162 | 2009-03-23 |
| 1023272069 | Aaron Christopher Hurlbut | Radiology | 12368 Stratford Dr, Suite 300, Clive, IA 50325-8162 | 2008-07-17 |
| 1689846008 | Christopher Scott Waddell | Radiology | 12368 Stratford Dr, Suite 300, Clive, IA 50325-8162 | 2008-03-26 |
| 1720250319 | Lindsey Lea Grandbois | Radiology | 12368 Stratford Dr, Suite 300, Clive, IA 50325-8162 | 2008-03-24 |
| 1295948206 | Bradley King | Radiology | 12368 Stratford Dr, Suite 300, Clive, IA 50325-8162 | 2007-05-07 |
| 1720145634 | Olaf Peter Kaufman | Radiology | 12368 Stratford Dr, Suite 300, Clive, IA 50325-8162 | 2007-01-02 |
| 1528026481 | Iowa Diagnostic Imaging & Procedure Center, Lc | Radiology | 12368 Stratford Dr, Suite 300, Clive, IA 50325-8162 | 2006-05-02 |
| 1336107283 | Iowa Radiology, P.C. | Radiology | 12368 Stratford Dr, Suite 300, Clive, IA 50325-8162 | 2006-05-02 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 50325 | ||||
| Taxonomy Code | 2085N0700X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Neuroradiology |
| A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861525396 | Aunt Minnie, Inc. | Radiology | 2124 Grand Ave, Des Moines, IA 50312-5304 | 2007-03-13 |
| 1184683393 | James C Beeler | Radiology | 5 Harvest Rd, Sioux City, IA 51104-1034 | 2006-03-17 |
| 1225645187 | Sinan Akay | Radiology | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-09-24 |
| 1033420286 | Brian D Hopper | Radiology | 1948 1st Ave Ne, Cedar Rapids, IA 52402-5321 | 2010-06-22 |
| 1093048019 | Jerry M Kovoor | Radiology | 200 Hawkins Dr, Iowa City, IA 52242-1007 | 2009-09-09 |
| 1477654853 | Siouxland Radiology Partners | Radiology | 801 5th St, Sioux City, IA 51101-1326 | 2006-09-26 |
| 1972610392 | Paul Robert Carpenter Jr. | Radiology | 801 5th St, Mercy Medical Center - Souix City, Sioux City, IA 51101-1326 | 2006-08-23 |
| 1063438299 | Colin P Derdeyn | Radiology | 200 Hawkins Dr, Rm 3966 Jpp, Iowa City, IA 52242-1009 | 2006-07-14 |
| 1306879069 | Bruno Adum Policeni | Radiology | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2006-07-08 |
| 1407832140 | Jack C Kademian | Radiology | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2005-12-15 |
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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.