NPIMap

Organization Active NPI

MRB Enterprises PC

  • Dentist
  • Blue Grass, IA
National Provider Identifier
1013141373
Registry record updated May 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7609 Issued in IA
Legal business name
MRB ENTERPRISES PC
Practice address
133 E Mayne St
Blue Grass, IA 52726-9718
Phone
(563) 381-4830
NPI assigned
May 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2009

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

Authorized official

Name
Dr. Philip Robert Bayne, D.D.S.NPI 1154355162
Title
Owner/President
Phone
(563) 381-4830

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 7609 IA Primary

Addresses

Primary practice location

133 E Mayne St
Blue Grass, IA 52726-9718

Mailing address

133 E Mayne St
Blue Grass, IA 52726-9718
Phone (563) 381-4830

Other identifiers 2

IdentifierTypeStateIssuer
11501OtherIABLUE CROSS BLUE SHIELD
1154355162OtherIATYPE I NPI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1242259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242259200000",
    "number": "1013141373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 E MAYNE ST",
            "city": "BLUE GRASS",
            "state": "IA",
            "postal_code": "527269718",
            "telephone_number": "563-381-4830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 E MAYNE ST",
            "city": "BLUE GRASS",
            "state": "IA",
            "postal_code": "527269718",
            "telephone_number": "563-381-4830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MRB ENTERPRISES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-14",
        "last_updated": "2009-05-14",
        "status": "A",
        "authorized_official_last_name": "BAYNE",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "563-381-4830",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IA",
            "license": "7609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "11501",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE I NPI",
            "identifier": "1154355162",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Grass, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2009; 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.