Basic Information
| Provider Information | |||||||||
| NPI: | 1932188380 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LOUIS SAUNDERS | ||||||||
| FirstName: | KATHARINE | ||||||||
| MiddleName: | JENNIFER | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SAUNDERS | ||||||||
| OtherFirstName: | KATHARINE | ||||||||
| OtherMiddleName: | JENNIFER LOUIS | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 200 HAWKINS DR | ||||||||
| Address2: | |||||||||
| City: | IOWA CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 522421009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | |||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1765 LININGER LN | ||||||||
| Address2: | |||||||||
| City: | NORTH LIBERTY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 523172335 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3194677888 | ||||||||
| FaxNumber: | 3194677889 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2006 | ||||||||
| LastUpdateDate: | 06/28/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 06/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 35746 | IA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 90541 | GA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0738146 | 05 | IA | MEDICAID | 2417691 | 05 | IA | MEDICAID | 25098 | 01 | IA | WELLMARK BCBS | OTHER | P00360469 | 01 | IA | RR MEDICARE | OTHER | 17168 | 01 | IA | WELLMARK BCBS | OTHER | 25099 | 01 | IA | WELLMARK BCBS | OTHER | 1417691 | 05 | IA | MEDICAID | 4417691 | 05 | IA | MEDICAID | 0417691 | 05 | IA | MEDICAID | 20786 | 01 | IA | WELLMARK BCBS | OTHER | 25107 | 01 | IA | WELLMARK BCBS | OTHER | 3417691 | 05 | IA | MEDICAID |