NPIMap

Individual provider Active NPI

Sommer J Grant, ARNP

  • Nurse Practitioner
  • Waterloo, IA
National Provider Identifier
1235116153
Registry record updated Oct 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
105635 Issued in IA
Practice address
146 W Dale St
Suite 201
Waterloo, IA 50703-1901
Phone
(319) 234-4431
Fax
(319) 235-5004
NPI assigned
Dec 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 105635 IA Primary

Addresses

Primary practice location

146 W Dale St
Suite 201
Waterloo, IA 50703-1901

Mailing address

146 W Dale St
Suite 201
Waterloo, IA 50703-1901
Phone (319) 234-4431

Other identifiers 1

IdentifierTypeStateIssuer
P00751284OtherIARR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050209000068 IA Practitioner - Nurse Practitioner 6800847625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iowa Physicians Clinic Medical FoundationGroup PAC ID 8729992318, 1,254 clinicians

Practice addresses (Care Compare)

1825 Logan Ave
Waterloo, IA 50703-1916
Phone (319) 235-3886

4480 Utica Ridge Rd
Bettendorf, IA 52722-1644

7511 University Ave
Cedar Falls, IA 50613-5027
Phone (319) 268-0401

Hospital & facility affiliations

  • Cedar Valley Hospice Hospice, Waterloo, IA, CCN 161504
  • Care Initiatives Hospice - Cedar Falls Hospice, Cedar Falls, IA, CCN 161593
  • Allen Hospital Hospital, Waterloo, IA, CCN 160110
  • Sartori Memorial Hospital, Inc Hospital, Cedar Falls, IA, CCN 160040
  • Unitypoint Health - Marshalltown Hospital, Marshalltown, IA, CCN 160001
  • Mercyone Waterloo Medical Center Hospital, Waterloo, IA, CCN 160067
  • The Suites at Western Home Communities Nursing home, Cedar Falls, IA, CCN 165622
  • Martin Health Center, INC Nursing home, Cedar Falls, IA, CCN 165508
  • Pinnacle Specialty Care Nursing home, Cedar Falls, IA, CCN 165298

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
105635IAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Methodist Hospital Current Accepting new patients
Iowa Physicians Clinic Medical Foundation CurrentSince Feb 16, 2014 Accepting new patients
Medical Laboratories of Eastern Iowa Past Accepting new patients
Raeford Family Care Center PC Past Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

1100 35th St
Marion, IA 52302
Phone (319) 377-1753

1825 Logan Ave
Ste 201
Waterloo, IA 50703

146 W Dale St
Ste 201
Waterloo, IA 50703
Phone (319) 234-4431

Interoperability endpoints

  • Direct secure messaging: sgrant108287@direct.unitypoint.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255996800000",
    "number": "1235116153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 W DALE ST",
            "address_2": "SUITE 201",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507031901",
            "telephone_number": "319-234-4431",
            "fax_number": "319-235-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 W DALE ST",
            "address_2": "SUITE 201",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507031901",
            "telephone_number": "319-234-4431",
            "fax_number": "319-235-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "SOMMER",
        "middle_name": "J",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-30",
        "last_updated": "2009-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "105635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00751284",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.