NPIMap

Organization Active NPI

St Charles Medical Clinic PLC

  • Family Medicine Physician
  • Saint Charles, IA
National Provider Identifier
1003910100
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
03050 Issued in IA
Legal business name
ST CHARLES MEDICAL CLINIC PLC
Practice address
101 E. Main St.
St Charles, IA 50240-1522
Phone
(515) 418-2883
NPI assigned
Sep 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Michael Gorski, DO
Title
President
Phone
(515) 238-9541

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 03050 IA Primary

Addresses

Primary practice location

101 E. Main St.
St Charles, IA 50240-1522

Mailing address

903 Redwood Dr
Norwalk, IA 50211-1421
Phone (515) 418-2883

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003910100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 REDWOOD DR",
            "city": "NORWALK",
            "state": "IA",
            "postal_code": "502111421",
            "telephone_number": "515-418-2883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E. MAIN ST.",
            "city": "ST CHARLES",
            "state": "IA",
            "postal_code": "502401522",
            "telephone_number": "515-418-2883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST CHARLES MEDICAL CLINIC PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GORSKI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-238-9541",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "03050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.