NPI 1194991109 · live from the CMS NPI Registry
Des Moines Pediatric & Adolescent Clinic
Pediatrics in Des Moines, IA. National Provider Identifier 1194991109, active.
NPI record
| NPI | 1194991109 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pediatrics 208000000X |
| Practice location | 2301 Beaver Ave, Des Moines, IA 50310 |
| Practice phone | 515-255-3181 |
| Enumerated | April 30, 2008 |
| Last updated | December 10, 2020 |
| Authorized official | Rob Fornoff, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics | 363LP0200X | — |
| Pediatrics primary | 208000000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.