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Contact Information

STADIA SPORTS MEDICINE PC
6000 UNIVERSITY AVE
SUITE 250
WEST DES MOINES, IA50266-8203
 Phone: 515-221-1102
 Fax: 515-221-1272
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neuromusculoskeletal Medicine, Sports Medicine

204C00000X 12 Physician/Osteopathic Manipulative Medicine
 

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for STADIA SPORTS MEDICINE PC

NPI Number 1962453274
LBN Legal business name STADIA SPORTS MEDICINE PC
Authorized official CHAD CARLSON - (CEO, STADIA SPORTS MEDICINE)
Entity Organization
Organization subpart 1 No
Enumeration date 05/12/2006
Last updated 08/16/2017 - About 9 years ago
Identifiers
IA License # 36501
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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