John Deere Medical Group of Waterloo, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

01585 Issued in IA

Legal business name

JOHN DEERE MEDICAL GROUP OF WATERLOO, PC

Practice address

1015 S Hackett Rd
Waterloo, IA 50701-3500

Phone

(319) 274-1000

Fax

(319) 292-6526

NPI assigned

Aug 15, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gregory L Hoekstra, D.O.NPI 1710091251

Title

Medical Director

Phone

(319) 274-1016

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Gregory L Hoekstra, D.O.

  • Specialist
  • Waterloo, IA
  • NPI 1710091251
  NPD (past) Authorized official

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063525277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 S HACKETT RD",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507013500",
            "telephone_number": "319-274-1000",
            "fax_number": "319-292-6526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 S HACKETT RD",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507013500",
            "telephone_number": "319-274-1000",
            "fax_number": "319-292-6526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN DEERE MEDICAL GROUP OF WATERLOO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOEKSTRA",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "319-274-1016",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IA",
            "license": "01585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1097592",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luiz Ramiro Jimenez
• Amy Jipp
• Sarah Christine Jocham
• Angela Joens
• Stephanie Johannsen, FNP-C
• Bradley Aaron Johnson, OD
• Isabella Johnson, T-LMHC
• James Corye Johnson, LISW
• Ma'Kaiyla Johnson
• Marcy J Johnson, ARNP

• Specialist in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Specialist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.