Healthcare Provider Details

I. General information

NPI: 1689594111
Provider Name (Legal Business Name): ASCENT INTEGRATED SPECIALISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2515 CYCLONE DR STE B
WATERLOO IA
50701-9715
US

IV. Provider business mailing address

2515 CYCLONE DR STE B
WATERLOO IA
50701-9715
US

V. Phone/Fax

Practice location:
  • Phone: 319-888-8044
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: KENNY DAVID RODRIGUEZ
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 720-998-1069