Charles J Latendresse

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CHARLES J LATENDRESSE

Practice address

1506 G Ave
Grundy Center, IA 50638-1038

Phone

(319) 824-3181

Fax

(319) 824-6680

NPI assigned

Dec 26, 2007

Last updated

Dec 26, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Charles J Latendresse, MDNPI 1245227743

Title

Owner

Phone

(319) 824-3181

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Charles J Latendresse, MD

  • Family Medicine Physician
  • Grundy Center, IA
  • NPI 1245227743
  Authorized official Same address or phone

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198627200000",
    "number": "1407030513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 128",
            "city": "GRUNDY CENTER",
            "state": "IA",
            "postal_code": "506380128",
            "telephone_number": "319-824-3181",
            "fax_number": "319-824-6680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 G AVE",
            "city": "GRUNDY CENTER",
            "state": "IA",
            "postal_code": "506381038",
            "telephone_number": "319-824-3181",
            "fax_number": "319-824-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES J LATENDRESSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-26",
        "last_updated": "2007-12-26",
        "status": "A",
        "authorized_official_last_name": "LATENDRESSE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-824-3181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trisha Ann Boos, PTA
• Wendy Brewer
• Lora Brunkhorst, COTA
• Calton V and S Pharmacy
• Cedar Valley Medical Specialists, PC (Ortho Surgery Dept/ Grundy)
• City of Grundy Center (Grundy Center Ambulance Service)
• Larry Clark, RNFA
• Douglas M Cooper, MD
• Creekside, Inc (Creekside)
• Margo Leann Doerdorff, OTR

• Family Medicine Physician in Grundy Center, IA
• Providers in Grundy Center, 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 Dec 26, 2007; 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.