Provider Demographics
NPI:1528165891
Name:NORTH KOSSUTH MEDICAL CLINIC
Entity type:Organization
Organization Name:NORTH KOSSUTH MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:515-272-4499
Mailing Address - Street 1:1914 IRVINGTON RD
Mailing Address - Street 2:
Mailing Address - City:ALGONA
Mailing Address - State:IA
Mailing Address - Zip Code:50511-8500
Mailing Address - Country:US
Mailing Address - Phone:515-272-4499
Mailing Address - Fax:515-295-7908
Practice Address - Street 1:202 3RD ST N
Practice Address - Street 2:BOX 296
Practice Address - City:SWEA CITY
Practice Address - State:IA
Practice Address - Zip Code:50590-1095
Practice Address - Country:US
Practice Address - Phone:515-272-4499
Practice Address - Fax:515-295-7908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA29211207Q00000X, 208600000X
IA883363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Not Answered363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA20024OtherWELLMARK BLUE CROSS
IA1094763Medicaid
MN48A98SCOtherBLUE CROSS
MNC03566Medicare ID - Type UnspecifiedGROUP NUMBER
IAI11912Medicare ID - Type UnspecifiedGROUP NUMBER
IA1094763Medicaid