Organization Active NPI

Neuropsychiatric Medicine Clinic PLLC

  • Child & Adolescent Psychiatry Physician
  • Clinton, IA
National Provider Identifier
1053627182
Registry record updated Aug 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
27692 Issued in IA
Legal business name
NEUROPSYCHIATRIC MEDICINE CLINIC PLLC
Practice address
511 S 3Rd St
Clinton, IA 52732-4357
Phone
(319) 217-2566
NPI assigned
Aug 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2010

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

Authorized official

Name
Dr. Joshua E Nnanji, MD
Title
Owner
Phone
(319) 217-2566

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0804X 27692 IA Primary

Addresses

Primary practice location

511 S 3Rd St
Clinton, IA 52732-4357

Mailing address

PO Box 321
Clinton, IA 52733-0321
Phone (319) 217-2566

Other identifiers 1

IdentifierTypeStateIssuer
27692OtherIDIOWA LICENSE

National Provider Directory

National Provider Directory

Locations

511 S 3rd St
Clinton, IA 52732
Phone (319) 217-2566

NPI Registry JSON

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282780800000",
    "number": "1053627182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 321",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527330321",
            "telephone_number": "319-217-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 S 3RD ST",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527324357",
            "telephone_number": "319-217-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROPSYCHIATRIC MEDICINE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-26",
        "last_updated": "2010-08-26",
        "status": "A",
        "authorized_official_last_name": "NNANJI",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-217-2566",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IA",
            "license": "27692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA LICENSE",
            "identifier": "27692",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; 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.