Basic Information
| Provider Information | |||||||||
| NPI: | 1386653707 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAHNER | ||||||||
| FirstName: | KEVIN | ||||||||
| MiddleName: | |||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1475 | ||||||||
| Address2: | |||||||||
| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503051475 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5156438100 | ||||||||
| FaxNumber: | 5156438139 | ||||||||
| Practice Location | |||||||||
| Address1: | 3815 STANGE RD | ||||||||
| Address2: | |||||||||
| City: | AMES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 500103914 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5159564044 | ||||||||
| FaxNumber: | 5159564075 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2006 | ||||||||
| LastUpdateDate: | 02/04/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 03018 | IA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | DO-03018 | IA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 71564 | 01 | IA | WELLMARK BLUE SHIELD | OTHER | 0463802 | 05 | IA | MEDICAID |