NPIMap

Organization Active NPI

Spanda Inc

  • Community Health Clinic/Center
  • Cedar Rapids, IA
National Provider Identifier
1124282637
Registry record updated Feb 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
SPANDA INC
Practice address
3235 Williams Parkway SW Ste 1
Cedar Rapids, IA 52404-1427
Phone
(319) 364-2311
Fax
(319) 366-3513
NPI assigned
Jul 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2012

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

Authorized official

Name
Dr. De Ann M Fitzgerald, O.D.NPI 1619958428
Title
Medical Director
Phone
(319) 366-3500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Community Health Clinic/Center 261QC1500X Primary

Addresses

Primary practice location

3235 Williams Parkway SW Ste 1
Cedar Rapids, IA 52404-1427

Mailing address

3235 Williams Parkway SW Ste 1
Cedar Rapids, IA 52404-1427
Phone (319) 364-2311

Other names 1

  • Cedar Rapids Vision In Motion Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090416000032 IA Part B Supplier - Clinic/Group Practice 7719034420 Receives reassigned benefits from 1 practitioner
Practice locations: Cedar Rapids, IA

National Provider Directory

National Provider Directory

Locations

3235 Williams Pkwy SW
Ste 1
Cedar Rapids, IA 52404
Phone (319) 364-2311

3235 Williams Pkwy SW
Cedar Rapids, IA 52404
Phone (319) 364-2311

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329264000000",
    "number": "1124282637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3235 WILLIAMS PARKWAY SW STE 1",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524041427",
            "telephone_number": "319-364-2311",
            "fax_number": "319-366-3513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3235 WILLIAMS PARKWAY SW STE 1",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524041427",
            "telephone_number": "319-364-2311",
            "fax_number": "319-366-3513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPANDA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-14",
        "last_updated": "2012-02-15",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "DE ANN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "319-366-3500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cedar Rapids Vision In Motion",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.