| Ikc, Llc | |
|
8736 Nw 27th Court Ankeny IA 50023 | |
| (515) 988-1584 | |
| Not Available |
| Full Name | Ikc, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8736 Nw 27th Court, Ankeny, Iowa |
| Authorized Official Name and Position | Shawn C Tulp (CHIEF OPERATIONS OFFICER) |
| Authorized Official Contact | 5203905411 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ikc, Llc 8736 Nw 27th Court Ankeny IA 50023 Ph: (515) 988-1584 | Ikc, Llc 8736 Nw 27th Court Ankeny IA 50023 Ph: (515) 988-1584 |
| NPI Number | 1659904803 |
|---|---|
| Provider Enumeration Date | 02/17/2020 |
| Last Update Date | 02/17/2020 |
| Medicare PECOS PAC ID | 5294140851 |
|---|---|
| Medicare Enrollment ID | O20210212002431 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659904803 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Mindy K Gingery |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124026042 PECOS PAC ID: 9931188042 Enrollment ID: I20040714000275 |
| Provider Name | Melissa A Rademacher |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1407856651 PECOS PAC ID: 7719979772 Enrollment ID: I20081023000759 |
| Provider Name | Mark L Hilliard |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336147339 PECOS PAC ID: 4183758006 Enrollment ID: I20100813001010 |
| Provider Name | Melissa A Snyder |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073836607 PECOS PAC ID: 0143473900 Enrollment ID: I20130104000202 |
| Provider Name | Malori J Khalil |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1629374590 PECOS PAC ID: 9931338449 Enrollment ID: I20140203001522 |
| Provider Name | Shannan N Schoening |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1750701009 PECOS PAC ID: 1052605805 Enrollment ID: I20160802002688 |
| Provider Name | Benjamin Blaylock |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1154708170 PECOS PAC ID: 6709156565 Enrollment ID: I20170727000192 |
| Provider Name | Shawn Tulp |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1255767778 PECOS PAC ID: 3678702834 Enrollment ID: I20200630002193 |
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