Aeon Group HST

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

AEON GROUP HST

Practice address

1801 E 54TH St
Suite 200
Davenport, IA 52807-7209

Phone

(563) 386-1904

Fax

(866) 899-2592

NPI assigned

Sep 10, 2012

Organization subpart

No

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

Authorized official

Name

Penny T Grunder

Title

Project Manager

Phone

(563) 386-1904

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347235200000",
    "number": "1457600157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 E 54TH ST",
            "address_2": "SUITE 200",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528077209",
            "telephone_number": "563-386-1904",
            "fax_number": "866-899-2592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 E 54TH ST",
            "address_2": "SUITE 200",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528077209",
            "telephone_number": "563-386-1904",
            "fax_number": "866-899-2592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEON GROUP HST",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-10",
        "last_updated": "2012-09-10",
        "status": "A",
        "authorized_official_last_name": "GRUNDER",
        "authorized_official_first_name": "PENNY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PROJECT MANAGER",
        "authorized_official_telephone_number": "563-386-1904"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Claire Adank, FNP-BC
• Olayinka A. Adedayo, M.D.
• Aina Nyenma Adekunle, M.D.
• Advanced Pain Control Center, PC
• Advanced Wellness Sports and Spine, PC
• Aeon Sleep Group
• Affluence Care LLC
• Nancy J Agnew, ARNP
• Ama Asantewaa Agyabeng, PHARMD
• Madisen Ahlstrom, PA-C

• Medical Specialty Clinic/Center in Davenport, IA
• Providers in Davenport, IA by specialty
• Medical Specialty Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2012; 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.