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STADIA SPORTS MEDICINE PC
NPI 1962453274
Neuromusculoskeletal Medicine, Sports Medicine in West Des Moines, IA

Active since May 12, 2006CLIA 16D1051696 · Waiver
7601 OFFICE PLAZA DR N STE 140, WEST DES MOINES, IA 50266(515) 221-1102(515) 221-1272 Get Directions Write a Review

NPPES record last updated: July 10, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 10, 2026, Aug 16, 2017 (2 updates tracked since 2017).

About Stadia Sports Medicine Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STADIA SPORTS MEDICINE PC (NPI 1962453274) is a healthcare organization registered as a neuromusculoskeletal medicine, sports medicine in West Des Moines, Iowa and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through March 7, 2028 and lists Chad Thomas Carlson, Ceo, Stadia Sports Medicine, as its authorized official.

NPPES Registry Identity

NPI1962453274
Entity TypeOrganization
Primary Taxonomy204C00000X
Legal Business NameSTADIA SPORTS MEDICINE PC
Location Address7601 OFFICE PLAZA DR N STE 140West Des Moines, IA 50266-1207
Mailing Address7601 Office Plaza Dr N Ste 140West Des Moines, IA 50266-1207 · (515) 221-1102 · Fax (515) 221-1272
Phone(515) 221-1102
Fax(515) 221-1272
Organization SubpartNo
Authorized OfficialChad Thomas CarlsonCeo, Stadia Sports Medicine · (515) 221-1102
Enumeration DateMay 12, 2006
Last NPPES UpdateJuly 10, 20262 updates tracked since enumeration
NPPES CertifiedJuly 10, 2026
✔ NPI 1962453274 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNeuromusculoskeletal Medicine, Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code204C00000X
License✔ Licensed in IA · 36501
Definition
A Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician trained to be responsible for the continuous care in the field of sports medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine and integrates each of these into the management of the individual engaged in physical exercise (sports) whether as an individual or in team participation. Source: American Osteopathic Association Additional Resources: AOA Osteopathic Board Certification in Neuromusculoskeletal Medicine; https://certification.osteopathic.org/sports-medicine/
Also ListedPhysical TherapistTaxonomy 225100000X
7601 OFFICE PLAZA DR N STE 140, West Des Moines, IA 50266
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stadia Sports Medicine Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

14

Medicare enrollment records show 14 clinicians reassign Medicare billing to Stadia Sports Medicine PC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 9 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 2

Physical Therapist in Private Practice13
Sports Medicine1

Clinicians, nearest first (14)

Chad Carlson, M.D.
Sports Medicine
NPI 1326008368
7601 OFFICE PLAZA DR N STE 140
West Des Moines, IA 50266
(515) 221-1102
✔ PECOS✔ Accepts MedicareSame address
Detlef Maltas, DPT
Physical Therapist in Private Practice
NPI 1841595535
6000 UNIVERSITY AVE STE 250
West Des Moines, IA 50266
(515) 221-1102
✔ Accepts Medicare1.1 mi
Catherine Mitchell, DPT
Physical Therapist in Private Practice
NPI 1437479953
5700 UNIVERSITY AVE SUITE 222
West Des Moines, IA 50266
(515) 221-1621
✔ Accepts Medicare1.6 mi
David Freeseman, PT
Physical Therapist in Private Practice
NPI 1790792067
5700 UNIVERSITY AVE STE 222
West Des Moines, IA 50266
(515) 221-1621
✔ Accepts Medicare1.6 mi
Samuel Huey, DPT
Physical Therapist in Private Practice
NPI 1194020487
5700 UNIVERSITY AVE SUITE 222
West Des Moines, IA 50266
(515) 221-1621
✔ Accepts Medicare1.6 mi
Phillip Mccullough, DPT
Physical Therapist in Private Practice
NPI 1740591411
5700 UNIVERSITY AVE STE 222
West Des Moines, IA 50266
(515) 221-1621
✔ Accepts Medicare1.6 mi
Donavon Greiner
Physical Therapist in Private Practice
NPI 1245616333
3205 GRAND AVE APT 201
Des Moines, IA 50312
(319) 461-2724
✔ Accepts Medicare7.8 mi
Robert Mortenson, DPT
Physical Therapist in Private Practice
NPI 1255885265
1905 INGERSOLL AVE STE 104
Des Moines, IA 50309
(515) 369-2306
✔ Accepts Medicare8.7 mi
Catherine Powell
Physical Therapist in Private Practice
NPI 1730954991
2526 GLENNOR RD
Des Moines, IA 50310
(309) 202-7659
8.8 mi
Logan Albaugh
Physical Therapist in Private Practice
NPI 1750750154
419 W BRIDGE RD STE A
Polk City, IA 50226
(515) 984-6377
✔ Accepts Medicare13 mi
Nicholas Grimoskas, PT
Physical Therapist in Private Practice
NPI 1578939690
609 SOUTH EAST KEND
Greenfield, IA 50849
(641) 743-2123
✔ Accepts Medicare39 mi
Joel Ingram
Physical Therapist in Private Practice
NPI 1831607019
235 8TH AVE W
Cresco, IA 52136
(563) 547-6361
✔ Accepts Medicare151 mi
Mackenzie Cichon
Physical Therapist in Private Practice
NPI 1245721851
1700 N DIVISION ST STE 200
Davenport, IA 52804
(563) 324-2263
✔ Accepts Medicare166 mi
Derek Klein, DPT
Physical Therapist in Private Practice
NPI 1366988180
850 43RD AVE # 3 SUITE 100
Moline, IL 61265
(309) 743-2070
✔ Accepts Medicare171 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 16D1051696

Stadia Sports Medicine · West Des Moines, IA
Active · expires Mar 7, 2028
CLIA Number16D1051696
Laboratory TypePhysician Office
Certificate Effective DateMarch 8, 2026
Certificate Expiration DateMarch 7, 2028
Laboratory DirectorChad T. Carlson
Laboratory Phone(515) 221-1102
Laboratory LocationStadia Sports Medicine7601 Office Plaza Dr N Ste 140, West Des Moines, IA 50266
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stadia Sports Medicine PC's NPI number?

The NPI number for Stadia Sports Medicine PC is 1962453274. It was assigned to this organization in the NPPES registry on May 12, 2006.

Where is Stadia Sports Medicine PC located?

Stadia Sports Medicine PC is located at 7601 Office Plaza Dr N Ste 140, West Des Moines, IA 50266. The listed phone number is (515) 221-1102.

What is Stadia Sports Medicine PC's specialty?

The primary specialty registered for this NPI is Neuromusculoskeletal Medicine, Sports Medicine with taxonomy code 204C00000X.

Is Stadia Sports Medicine PC enrolled in Medicare?

Yes. Stadia Sports Medicine PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Stadia Sports Medicine PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 14 clinicians in 2 Medicare specialties reassign their Medicare billing to Stadia Sports Medicine PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Physical Therapist in Private Practice (13) and Sports Medicine (1). Of these, 1 practice at this address and 9 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Stadia Sports Medicine PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 16D1051696) is associated with this NPI, valid through March 7, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Stadia Sports Medicine PC was last updated on July 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.