Healthcare Provider Details

I. General information

NPI: 1043120397
Provider Name (Legal Business Name): FAS MS IOWA PHYSICIANS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6165 NW 86TH ST 1ST & 2ND FLOOR
JOHNSTON IA
50131-2240
US

IV. Provider business mailing address

PO BOX 607
CENTERVILLE UT
84014-0607
US

V. Phone/Fax

Practice location:
  • Phone: 515-203-3218
  • Fax:
Mailing address:
  • Phone: 515-203-3218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. NATHAN PAYNE
Title or Position: OWNER
Credential: MD
Phone: 801-368-0512