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General NPI Number Information
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NPI Number | 1407551120
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Entity Type | Organization
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Legal Business Name | OAK STREET HEALTH PHYSICIANS GROUP OF IOWA LLC
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Dates
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Enumeration Date | 04/03/2023
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 4841 SE 14TH ST
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City | DES MOINES
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State | IA
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Zip | 50320-1616
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Country | US
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Telephone | 515-415-4081
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Fax | 515-506-5085
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Provider Business Mailing Address
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Address Line | PO BOX 746870
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City | ATLANTA
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State | GA
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Zip | 30374-6870
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Country | US
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Telephone | 773-352-1515
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Fax | 312-929-0373
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Authorized Official
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Title or Position | CMO
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Name | DR. TERRENCE MORTON
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Credential | MD
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Telephone | 704-607-4835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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