Grand View University

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

MD-37318 Issued in IA

Legal business name

GRAND VIEW UNIVERSITY

Doing business as

Grand View Sports Medicine

Practice address

1200 Grandview Ave
Des Moines, IA 50316-1529

Phone

(972) 367-4845

NPI assigned

Dec 1, 2017

Organization subpart

No

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

Authorized official

Name

Mouzon Bass III

Title

Agent

Phone

(972) 367-4845

Specialties & licenses 1

Addresses

Other names 1

• Grand View Sports Medicine Doing business as

Tax ID family

Grand View Health Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Grand View University

  dba Grand View Health Services

  • Pediatric Adolescent Medicine Physician
  • Des Moine, IA
  • NPI 1861908089
  NPD tax ID

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

{
    "created_epoch": "1512086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512086400000",
    "number": "1245745074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 SPRING VALLEY RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 GRANDVIEW AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503161529",
            "telephone_number": "972-367-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND VIEW UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-01",
        "last_updated": "2017-12-01",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "MOUZON",
        "authorized_official_title_or_position": "AGENT",
        "authorized_official_telephone_number": "972-367-4845",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IA",
            "license": "MD-37318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand View Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura Grage
• Emily R Graham, RD, LD, CDE
• Thomas Earl Graham, RN
• Tracy Graham
• Sean T Grambart, DPM
• Keyana Graney, TLMHC
• Alexa Grant, RDN
• Sarah Grantham, RN, BSN, CLS, NTM
• Robert E Grask, DDS
• Alicia Marie Grassley, ARNP

• Sports Medicine (Orthopaedic Surgery) Physician in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2017; 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.