Iowa Physicians Clinic Medical Foundation

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION

Practice address

101 E J Ave
Ste 120
Grundy Center, IA 50638-2006

Phone

(319) 824-6945

Fax

(319) 824-6947

NPI assigned

Jun 20, 2006

Organization subpart

Yes

Parent organization

IOWA PHYSICIANS CLINIC MEDICAL FOUNDATIONAs reported in NPPES

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

Authorized official

Name

Erick J Laine

Title

Coo

Phone

(515) 471-9227

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Grundy Center Family Medicine Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Part of

Jeffrey Carandall MD

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Unitypoint Health - Marshalltown

  • Rural Health Clinic/Center
  • Grundy Center, IA
  • NPI 1255977740

  Sold to, 2019-12-22

  CMS change of ownership

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344988800000",
    "number": "1013952183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 BIRCHWOOD COURT",
            "address_2": "SUITE R",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312930",
            "telephone_number": "515-471-9243",
            "fax_number": "515-471-9319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E J AVE",
            "address_2": "STE 120",
            "city": "GRUNDY CENTER",
            "state": "IA",
            "postal_code": "506382006",
            "telephone_number": "319-824-6945",
            "fax_number": "319-824-6947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION",
        "enumeration_date": "2006-06-20",
        "last_updated": "2012-08-15",
        "status": "A",
        "authorized_official_last_name": "LAINE",
        "authorized_official_first_name": "ERICK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "515-471-9227"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0689539",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grundy Center Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Grundy County Memorial Hospital
• Grundy County Memorial Hospital
• Grundy County Memorial Hospital
• GRX Holdings LLC
• Heart and Solutions
• Jansen Optical
• John Robert Jansen
• John Allen Jensen Sr., R.PH.
• Julie Johnson, PSYD, LMHC
• Frank Lee Lamp, M.D.

• All providers in Grundy Center, IA
• Rural Health Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.