Healthcare Provider Details

I. General information

NPI: 1588543912
Provider Name (Legal Business Name): JONAH BEER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 11/23/2025
Certification Date: 11/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 LAUREL ST STE A250
DES MOINES IA
50314-3029
US

IV. Provider business mailing address

PO BOX 677080
DALLAS TX
75267-7080
US

V. Phone/Fax

Practice location:
  • Phone: 515-235-5000
  • Fax: 515-288-6713
Mailing address:
  • Phone: 515-633-3600
  • Fax: 515-633-3838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number134495
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: