Provider Demographics
NPI:1629018973
Name:PLANNED PARENTHOOD OF THE HEARTLAND
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD OF THE HEARTLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:CARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-235-0420
Mailing Address - Street 1:PO BOX 4557
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-4557
Mailing Address - Country:US
Mailing Address - Phone:866-290-4325
Mailing Address - Fax:515-280-9525
Practice Address - Street 1:30 N 27TH STREET
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-3710
Practice Address - Country:US
Practice Address - Phone:866-290-4325
Practice Address - Fax:515-280-9525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01898207Q00000X
IAF084106363LW0102X
IAF084718363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0057570Medicaid
IA0057570Medicaid
IAA02049Medicare UPIN
IAP15625Medicare UPIN
IAI0623Medicare ID - Type Unspecified