| Center Stage Primary Care | |
|
1000 73rd St Ste 23 West Des Moines IA 50265-1321 | |
| (515) 267-1961 | |
| (515) 225-4427 |
| Full Name | Center Stage Primary Care |
|---|---|
| Speciality | Family Medicine |
| Location | 1000 73rd St Ste 23, West Des Moines, Iowa |
| Authorized Official Name and Position | Malea Ann Jensen (PRESIDENT) |
| Authorized Official Contact | 5152671961 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center Stage Primary Care 1000 73rd St Ste 23 West Des Moines IA 50265-1321 Ph: (515) 267-1961 | Center Stage Primary Care 1000 73rd St Ste 23 West Des Moines IA 50265-1321 Ph: (515) 267-1961 |
| NPI Number | 1427300623 |
|---|---|
| Provider Enumeration Date | 10/11/2012 |
| Last Update Date | 03/19/2021 |
| Medicare PECOS PAC ID | 7719138551 |
|---|---|
| Medicare Enrollment ID | O20121105000028 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427300623 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 03029 (Iowa) | Primary |
| Provider Name | Malea Ann Jensen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740241942 PECOS PAC ID: 5395808380 Enrollment ID: I20090119000011 |
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