1528165891 NPI number — NORTH KOSSUTH MEDICAL CLINIC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528165891 NPI number — NORTH KOSSUTH MEDICAL CLINIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTH KOSSUTH MEDICAL CLINIC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528165891
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/11/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1914 IRVINGTON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALGONA
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50511-8500
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
515-272-4499
Provider Business Mailing Address Fax Number:
515-295-7908

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
202 3RD ST N
Provider Second Line Business Practice Location Address:
BOX 296
Provider Business Practice Location Address City Name:
SWEA CITY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50590-1095
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-272-4499
Provider Business Practice Location Address Fax Number:
515-295-7908
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SCHER
Authorized Official First Name:
ALAN
Authorized Official Middle Name:
DAVID
Authorized Official Title or Position:
OWNER/PHYSICIAN
Authorized Official Telephone Number:
515-272-4499

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  29211 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: 29211 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X , with the licence number: 883 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 20024 . This is a "WELLMARK BLUE CROSS" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 1094763 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 48A98SC . This is a "BLUE CROSS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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