IOWA DERMATOLOGY CLINIC PLC (NPI# 1932604113) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932604113 |
| Entity Type | Organization |
| Organization Name | IOWA DERMATOLOGY CLINIC PLC |
| Other Organization Name | RADIANT COMPLEXIONS DERMATOLOGY CLINIC |
| Practice Address |
2105 Ingersoll Ave Ste 101 Des Moines IA 50312-5201 |
| Mailing Address |
6800 Lake Dr Ste 285 West Des Moines IA 50266-2544 |
| Practice Telephone | 5152263116 |
| Mailing Telephone | 5154232606 |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2018-03-28 |
| Authorized Official Name | MATTHEW DAVID SCHEMMEL (VICE PRESIDENT) |
| Authorized Official Telephone | 5152263116 |
| 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 |
|---|---|---|---|---|
| 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 |
| 1356846414 | Iowa Dermatology Clinic Plc | Clinic/Center | 3053 8th Street, Suite 200, Altoona, IA 50009 | 2018-03-29 |
| 1972023414 | Iowa Dermatology Clinic Plc | Dermatology | 9500 University Ave Ste 1114, West Des Moines, IA 50266-1745 | 2017-06-26 |
| 1982942702 | Iowa Dermatology Clinic Plc | Dermatology | 26 S 1st Ave, Suite 100, Marshalltown, IA 50158-5032 | 2013-01-29 |
| 1427067214 | Iowa Dermatology Clinic Plc | Dermatology | 3613 Beaver Ave, Des Moines, IA 50310-3273 | 2006-08-08 |
| 1316581622 | Iowa Dermatology Clinic Plc | Dermatology | 1327 Sunset Drive, Suite 200, Norwalk, IA 50211-1343 | 2019-10-30 |
| 1679062848 | Iowa Dermatology Clinic Plc | Dermatology | 22 N 27th St, Fort Dodge, IA 50501-4331 | 2018-05-03 |
| 1255679163 | Iowa Dermatology Clinic Plc | Clinical Medical Laboratory | 6000 University Ave, Suite 350, West Des Moines, IA 50266-8203 | 2013-01-28 |
| 1871607531 | Iowa Dermatology Clinic Plc | Dermatology | 5921 Se 14th St, Suite 2500, Des Moines, IA 50320-1746 | 2006-08-19 |
| Street Address |
2105 INGERSOLL AVE STE 101 |
| City | DES MOINES |
| State | IA |
| Zip Code | 50312-5201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346784808 | Ashley Grace Brown | Nurse Practitioner | 2105 Ingersoll Ave Ste 101, Des Moines, IA 50312-5201 | 2016-12-16 |
| 1265971329 | Robin Westrum | Nurse Practitioner | 2105 Ingersoll Ave Ste 101, Des Moines, IA 50312-5201 | 2017-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942837976 | Devon Anderson | Student in an Organized Health Care Education/Training Program | Des Moines University Pa Program, 3200 Grand, Des Moines, IA 50312 | 2020-03-27 |
| 1578190583 | Christian Ostrander | Student in an Organized Health Care Education/Training Program | Des Moines University-pa Program 3200 Grand Avenue, Des Moines, IA 50312 | 2020-03-27 |
| 1194209312 | Margaret Dedecker | Speech-Language Pathologist | 644 24th St., Des Moines, IA 50312 | 2018-09-24 |
| 1942702410 | Nelson-kirby Therapy & Consulting Services, LLC | Marriage & Family Therapist | 3900 Ingersoll Avenue Suite 108, Des Moines, IA 50312 | 2018-03-01 |
| 1851839864 | Lawrence Scanlon | Counselor | 412 42nd St, Des Moines, IA 50312 | 2017-02-09 |
| 1104275122 | Melissa Joshel | Social Worker | 2116 Grand Ave Ste 2, Des Moines, IA 50312 | 2016-06-09 |
| 1629435813 | Abby Michele Miller | Acupuncturist | 531 40th Street, Des Moines, IA 50312 | 2016-01-20 |
| 1326410689 | Dawn Theresa Corriere | Advanced Practice Midwife | 3714 Ingersoll Ave, Des Moines, IA 50312 | 2015-10-27 |
| 1336558154 | Paul Johnston | Counselor | 600 42nd Street, Des Moines, IA 50312 | 2014-08-06 |
| 1083847214 | Mark David Ravreby | Internal Medicine | 3663 Grand Ave, #204, Des Moines, IA 50312 | 2009-09-04 |
| Find all providers in zip 50312 | ||||
| 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 |
|---|---|---|---|---|
| 1427067214 | Iowa Dermatology Clinic Plc | Dermatology | 3613 Beaver Ave, Des Moines, IA 50310-3273 | 2006-08-08 |
| 1427618347 | Britt K Deruyter | Dermatology | 1801 Hickman Rd, Des Moines, IA 50314-1505 | 2019-06-13 |
| 1508238395 | Iowa Dermatology Clinic, Plc | Dermatology | 5921 Se 14th St, Suite 2500, Des Moines, IA 50320-1746 | 2015-10-20 |
| 1871607531 | Iowa Dermatology Clinic Plc | Dermatology | 5921 Se 14th St, Suite 2500, Des Moines, IA 50320-1746 | 2006-08-19 |
| 1750332284 | Mirza Baig | Dermatology | 3520 Beaver Ave, Suite G, Des Moines, IA 50310-3264 | 2006-05-12 |
| 1073598512 | Jared J Abbott | Dermatology | 1212 Pleasant, Suite # Ll3, Des Moines, IA 50309-1414 | 2005-12-07 |
| 1396739850 | John William Holtze | Dermatology | 1221 Pleasant St, Ste 500, Des Moines, IA 50309 | 2005-09-09 |
| 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 |
| 1083086862 | Iowa Dermatology Clinic, Plc | Dermatology | 3729 86th St, Urbandale, IA 50322 | 2015-10-20 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | DES MOINES |
| Zip Code | 50312 |
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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.