Storm Lake Medical, P.C.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

STORM LAKE MEDICAL, P.C.

Practice address

801 Hudson St
Storm Lake, IA 50588-2213

Phone

(712) 213-3349

Fax

(712) 732-5493

NPI assigned

Jan 24, 2017

Last updated

Apr 30, 2022By 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

Mr. Timothy W Redenbaugh, D.C.NPI 1093773780

Title

Owner

Phone

(712) 732-3349

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.

• Timothy William Redenbaugh, DC

  • Chiropractor
  • Storm Lake, IA
  • NPI 1093773780
  NPD Authorized official

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

{
    "created_epoch": "1485216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651276800000",
    "number": "1457898801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 HUDSON ST",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "505882213",
            "telephone_number": "712-213-3349",
            "fax_number": "712-732-5493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 HUDSON ST",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "505882213",
            "telephone_number": "712-213-3349",
            "fax_number": "712-732-5493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STORM LAKE MEDICAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-24",
        "last_updated": "2022-04-30",
        "certification_date": "2022-04-30",
        "status": "A",
        "authorized_official_last_name": "REDENBAUGH",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "712-732-3349",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Megan Alta Sullivan, O.D.
• Tracy Ann Thomas, PH.D.
• TKC Optical (Exact Eye Care)
• TKC Optical, Inc (Exact Eye Care)
• Trimark Physicians Group (UnityPoint Clinic - Foot and Ankle - Storm Lake)

• Nurse Practitioner in Storm Lake, IA
• Providers in Storm Lake, IA by specialty
• Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2022; 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.