NPIMap

Organization Active NPI

Grinnell Regional Medical Center

Doing business as Deer Creek Family Care

  • Family Medicine Physician
  • Toledo, IA
National Provider Identifier
1023498573
Registry record updated Aug 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GRINNELL REGIONAL MEDICAL CENTER
Doing business as
Deer Creek Family Care
Practice address
401 1St Ave
Toledo, IA 52342-2129
Phone
(641) 484-2602
Fax
(641) 484-6837
NPI assigned
May 30, 2015
Last updated
Aug 3, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
GRINNELL REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 3, 2015

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

Authorized official

Name
Todd C Linden
Title
President & Ceo
Phone
(641) 236-7511

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Physician Assistant 363A00000X NU

Addresses

Primary practice location

401 1St Ave
Toledo, IA 52342-2129

Mailing address

210 4TH Ave
Grinnell, IA 50112-1898
Phone (641) 236-7511

Other names 1

  • DEER CREEK FAMILY CARE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040127001219 IA Part B Supplier - Clinic/Group Practice 0446153662 Receives reassigned benefits from 173 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pella, IA; Waterloo, IA; Robins, IA; Oskaloosa, IA; Marshalltown, IA; Marion, IA; Kalona, IA; Iowa City, IA…

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Memorial Clinic

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1432944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438560000000",
    "number": "1023498573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 4TH AVE",
            "city": "GRINNELL",
            "state": "IA",
            "postal_code": "501121898",
            "telephone_number": "641-236-7511",
            "fax_number": "641-236-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 1ST AVE",
            "city": "TOLEDO",
            "state": "IA",
            "postal_code": "523422129",
            "telephone_number": "641-484-2602",
            "fax_number": "641-484-6837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRINNELL REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRINNELL REGIONAL MEDICAL CENTER",
        "enumeration_date": "2015-05-30",
        "last_updated": "2015-08-03",
        "status": "A",
        "authorized_official_last_name": "LINDEN",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "641-236-7511"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DEER CREEK FAMILY CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Toledo, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.