Internal Medicine of Council Bluffs P.C.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

19162 Issued in IA

Legal business name

INTERNAL MEDICINE OF COUNCIL BLUFFS P.C.

Practice address

25 S 15TH St
Suite 1
Council Bluffs, IA 51501-3900

Phone

(712) 323-0062

Fax

(712) 323-5369

NPI assigned

Mar 7, 2008

Organization subpart

No

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

Authorized official

Name

Ruben Altman, MD

Title

President

Phone

(712) 323-0062

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1295905099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 S 15TH ST",
            "address_2": "SUITE 1",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515013900",
            "telephone_number": "712-323-0062",
            "fax_number": "712-323-5369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 S 15TH ST",
            "address_2": "SUITE 1",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515013900",
            "telephone_number": "712-323-0062",
            "fax_number": "712-323-5369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE OF COUNCIL BLUFFS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-07",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "ALTMAN",
        "authorized_official_first_name": "RUBEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "712-323-0062",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IA",
            "license": "19162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0092007",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Council Bluffs, IA
• Primary Care Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; 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.