PRAIRIE TRAILS EMERGENCY PHYSICIANS (NPI# 1972894665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972894665 |
| Entity Type | Organization |
| Organization Name | PRAIRIE TRAILS EMERGENCY PHYSICIANS |
| Practice Address |
417 S East St Corydon IA 50060-1860 |
| Mailing Address |
815 S Palafox St 3rd Floor Pensacola FL 32502-5960 |
| Practice Telephone | 6418725240 |
| Practice Fax Number | 8003053233 |
| Mailing Telephone | 8004447009 |
| Mailing Fax Number | 8003053233 |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2011-04-28 |
| Authorized Official Name | JOSEPH W TAYLOR (EXECUTIVE VICE PRESIDENT EMCARE PHY) |
| Authorized Official Telephone | 8004447009 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | PRAIRIE TRAILS EMERGENCY PHYSICIANS, LLC | 7700 W. Sunrise Boulevvard, Plantation, FL 33322 |
| Street Address |
417 S EAST ST |
| City | CORYDON |
| State | IA |
| Zip Code | 50060-1860 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285627323 | Babar S. Ahmed | Family Medicine | 417 S East St, Corydon, IA 50060-1860 | 2005-08-24 |
| 1265042055 | Adam Rowland | Nurse Practitioner | 417 S East St, Corydon, IA 50060-1860 | 2020-08-06 |
| 1649880451 | Angela M Downs | Nurse Practitioner | 417 S East St, Corydon, IA 50060-1835 | 2020-08-06 |
| 1114568870 | Kelcey Diane Leopard | Registered Nurse | 417 S East St, Corydon, IA 50060-1835 | 2019-10-03 |
| 1740764661 | Cortney Serene Wilson | Specialist/Technologist, Other | 417 S East St, Corydon, IA 50060-1860 | 2018-09-17 |
| 1386149680 | Rachel Mcilwain | Dietitian, Registered | 417 S East St, Corydon, IA 50060-1835 | 2018-03-28 |
| 1174937494 | Stephanie Jo Perkins Mahan | Family Medicine | 417 S East St, Corydon, IA 50060-1860 | 2014-06-14 |
| 1730518150 | Southern Iowa Orthopedics LLC | Podiatrist | 417 S East St, Corydon, IA 50060-1860 | 2013-11-06 |
| 1447500418 | Lk Madison Md LLC | Radiology | 417 S East St, Corydon, IA 50060-1860 | 2012-09-17 |
| 1457608911 | Nicole Marie Ruble | Physician Assistant | 417 S East St, Corydon, IA 50060-1860 | 2012-08-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922214246 | Deborah Nadarevic | Pharmacist | Your Neighborhood Pharmacy, 510 E. Jefferson Street Suite A, Corydon, IA 50060 | 2007-05-15 |
| 1669697074 | Community Health Centers of Southern Iowa, Inc | Clinic/Center | 102-104 North Franklin St, Corydon, IA 50060 | 2007-04-13 |
| 1336290030 | Wolfe Clinic Eye Centers, Lc | Eyewear Supplier (Equipment, not the service) | 212 N Franklin Street, Corydon, IA 50060 | 2007-01-16 |
| 1912067455 | C and J Quality Jobs LLC | Contractor | 610 West Maple St, Corydon, IA 50060 | 2006-12-12 |
| 1417941188 | Debra Kay Neuharth | Family Medicine | 410 South Lincoln St, Corydon, IA 50060 | 2005-09-08 |
| 1922090752 | Charles A Clark | Optometrist | 212 N Franklin St, Corydon, IA 50060-1328 | 2005-08-18 |
| 1255488938 | Wayne Community School District | Local Education Agency (LEA) | 102 N Dekalb St, Corydon, IA 50060-1403 | 2007-01-04 |
| 1720607401 | Duane P Schmaltz | Pharmacist | 105 E Jackson St, Corydon, IA 50060-1408 | 2020-04-13 |
| 1669887642 | Hy Vee Inc | Pharmacy | 105 E Jackson St, Corydon, IA 50060-1408 | 2014-06-27 |
| 1336132588 | Corydon Pharmacy Inc | Pharmacy | 104 S Franklin St, Corydon, IA 50060-1518 | 2005-08-23 |
| Find all providers in zip 50060 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336256361 | Harrison County Hospital | Emergency Medicine | 1141 Hospital Dr Nw, Corydon, IN 47112-2164 | 2006-08-24 |
| 1356327613 | Thomas R Radice | Emergency Medicine | 3292 Dixie Rd Sw, Corydon, IN 47112-0007 | 2005-12-19 |
| 1326286626 | Constitution Elm Emergency Physicians LLC | Emergency Medicine | 1141 Hospital Dr Nw, Corydon, IN 47112-2164 | 2009-01-26 |
| 1215137666 | Michael John Savino | Emergency Medicine | 1141 Hospital Dr Nw, Corydon, IN 47112-2164 | 2007-07-24 |
| 1255387825 | Graydon B Cummins | Emergency Medicine | 245 Atwood St, Corydon, IN 47112-1738 | 2006-05-25 |
| 1649224601 | Marvin Rush | Emergency Medicine | 245 Atwood St, Corydon, IN 47112-1738 | 2006-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275151003 | Linn County Emergency Medicine PC | Emergency Medicine | 1195 Boyson Rd Ste 101, Hiawatha, IA 52233-2218 | 2020-07-08 |
| 1245795087 | Gabriel Alejandro Hernandez Roman | Emergency Medicine | 200 Hawkins Dr Dept of Emergency Medicine, Iowa Cit, IA 52242-1009 | 2019-02-06 |
| 1821527862 | Ashley Nicole Evans | Emergency Medicine | 420 Community Dr, North Liberty, IA 52317-6706 | 2017-06-04 |
| 1457715047 | Benjamin Rezny | Emergency Medicine | 200 Hawkins Dr Dept of Anesthesia, Iowa City, IA 52242-1009 | 2016-04-08 |
| 1407293236 | Austin Koch | Emergency Medicine | 200 Hawkins Drive, 1008 Rcp, Uihc - Emergency Medicine, Iowa City, IA 52242 | 2013-06-03 |
| 1588900880 | Ottumwa Er LLC | Emergency Medicine | 1001 Pennsylvania Avenue, Ottumwa, IA 52501 | 2012-12-14 |
| 1336403419 | William E Kettelkamp | Emergency Medicine | 2760 E Robins Rd, Marion, IA 52302-9525 | 2012-07-03 |
| 1578827465 | Sandy Kay Clayton | Emergency Medicine | 901 Montgomery St., Medical Staff Services, Decorah, IA 52101-2325 | 2012-06-26 |
| 1821356015 | Brandon Charles Whalen | Emergency Medicine | 200 Hawkins Dr, 1008 Rcp, Iowa City, IA 52242 | 2012-04-25 |
| 1730407545 | Randall Glen Wood | Emergency Medicine | 2720 Stone Park Blvd., Sioux City, IA 51104 | 2010-05-04 |
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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.