=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982434494
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PATHWAY CLINICAL IOWA PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/07/2024
-----------------------------------------------------
Last Update Date | 08/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 215 4TH AVE SE STE 300
-----------------------------------------------------
City | CEDAR RAPIDS
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52401-1844
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-208-9312
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1000 URBAN CENTER DR STE 600
-----------------------------------------------------
City | VESTAVIA
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35242-2584
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/COO
-----------------------------------------------------
Name | ANDREW TURNER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 205-208-9312
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207QA0401X
-----------------------------------------------------
Taxonomy Name | Addiction Medicine (Family Medicine) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------