NPIMap

Organization Active NPI

Grondel Urgent Care of Henderson, PLLC

Doing business as St. Rose Walk-in Care

  • Urgent Care Clinic/Center
  • Henderson, NV
National Provider Identifier
1194057505
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
GRONDEL URGENT CARE OF HENDERSON, PLLC
Doing business as
St. Rose Walk-in Care
Practice address
10561 Jeffreys St
Suite 100
Henderson, NV 89052-4266
Phone
(702) 478-5620
Fax
(702) 478-5093
NPI assigned
Feb 10, 2010
Last updated
Sep 26, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

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

Authorized official

Name
Gordon Bruinsma
Title
Authorized Official
Phone
(616) 293-4769

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

10561 Jeffreys St
Suite 100
Henderson, NV 89052-4266

Mailing address

PO Box 629
Altoona, IA 50009-0629
Phone (515) 645-9911

Other names 1

  • St. Rose Walk-in Care Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1265760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411689600000",
    "number": "1194057505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 629",
            "city": "ALTOONA",
            "state": "IA",
            "postal_code": "500090629",
            "telephone_number": "515-645-9911",
            "fax_number": "515-967-5581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10561 JEFFREYS ST",
            "address_2": "SUITE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524266",
            "telephone_number": "702-478-5620",
            "fax_number": "702-478-5093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRONDEL URGENT CARE OF HENDERSON, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-10",
        "last_updated": "2014-09-26",
        "status": "A",
        "authorized_official_last_name": "BRUINSMA",
        "authorized_official_first_name": "GORDON",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "616-293-4769"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Rose Walk-in Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; 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.