Active NPI
Physicians Clinic, Inc.
Doing business as Methodist Physicians Clinic
- Durable Medical Equipment & Medical Supplies
- Glenwood, IA
National Provider Identifier
1023105855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- PHYSICIANS CLINIC, INC.
- Doing business as
- Methodist Physicians Clinic
- Practice address
- 320 Ebaugh Street
Glenwood, IA 51534 - Phone
- (712) 527-5204
- Fax
- (712) 527-9346
- NPI assigned
- Oct 5, 2006
- Last updated
- Oct 7, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Todd D. Grages
- Title
- President
- Phone
- (402) 354-5601
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
320 Ebaugh Street
Glenwood, IA 51534
Mailing address
8601 West Dodge Road
Suite # 216
Omaha, NE 68114
Phone (402) 354-5451
Other names 1
- Methodist Physicians Clinic
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D0385839 | Methodist Physicians Clinic - Glenwood | Accreditation | Jun 2, 2027 |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1412640000000",
"number": "1023105855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8601 WEST DODGE ROAD",
"address_2": "SUITE # 216",
"city": "OMAHA",
"state": "NE",
"postal_code": "68114",
"telephone_number": "402-354-5451",
"fax_number": "402-354-5454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 EBAUGH STREET",
"city": "GLENWOOD",
"state": "IA",
"postal_code": "51534",
"telephone_number": "712-527-5204",
"fax_number": "712-527-9346"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PHYSICIANS CLINIC, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-05",
"last_updated": "2014-10-07",
"status": "A",
"authorized_official_last_name": "GRAGES",
"authorized_official_first_name": "TODD",
"authorized_official_middle_name": "D.",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "402-354-5601",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Methodist Physicians Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Glenwood, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.