Jordan Creek Family Medical Clinic PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35490 Issued in IA

Legal business name

JORDAN CREEK FAMILY MEDICAL CLINIC PC

Practice address

230 S 68TH St
Suite 220
West Des Moines, IA 50266-8176

Phone

(515) 457-8517

NPI assigned

Jun 28, 2006

Organization subpart

No

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

Authorized official

Name

Basil Saadi Hassan, M.D.NPI 1932180437

Title

President/Ceo

Phone

(515) 457-8517

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72558

Practitioners 3

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

• Basil S. Hassan, MD

  • Family Medicine Physician
  • West Des Moines, IA
  • NPI 1932180437
  Medicare reassignment NPD Authorized official
• Dale Miller Grunewald, D.O.

  • Family Medicine Physician
  • West Des Moines, IA
  • NPI 1871595207
  NPD
• Dawn Marie Schissel, MD

  • Family Medicine Physician
  • West Des Moines, IA
  • NPI 1396730412
  NPD

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356378772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 S 68TH ST",
            "address_2": "SUITE 220",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502668176",
            "telephone_number": "515-457-8517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 S 68TH ST",
            "address_2": "SUITE 220",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502668176",
            "telephone_number": "515-457-8517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORDAN CREEK FAMILY MEDICAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HASSAN",
        "authorized_official_first_name": "BASIL",
        "authorized_official_middle_name": "SAADI",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "515-457-8517",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "35490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly C Joliet, D.O.
• Aaliyah Jones
• Elisabeth Lee Jones, ARNP, FNP-C
• Kathleen Sue Jones, MD
• Tierany Dawn Jones, P.T.A.
• Jordan Creek Pediatric Dentistry
• Jordan Creek Pediatric Dentistry, Inc
• Clayton Wayne Jordan, D.O.
• Lisa Jordan
• Trina Karene Jorgensen, PT

• Family Medicine Physician in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.