Individual provider Active NPI

Janet Graeve, MD

  • Pediatrics Physician
  • Des Moines, IA
National Provider Identifier
1508974734
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25631 Issued in IA
Practice address
330 Laurel St
Suite 2100
Des Moines, IA 50314-3034
Phone
(515) 643-8611
NPI assigned
Aug 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25631 IA Primary

Addresses

Primary practice location

330 Laurel St
Suite 2100
Des Moines, IA 50314-3034

Mailing address

1055 6TH Ave
Suite 200
Des Moines, IA 50314-2607
Phone (515) 643-8672

Other identifiers 1

IdentifierTypeStateIssuer
1273037MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25631IAMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508974734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 6TH AVE",
            "address_2": "SUITE 200",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503142607",
            "telephone_number": "515-643-8672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 LAUREL ST",
            "address_2": "SUITE 2100",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503143034",
            "telephone_number": "515-643-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAEVE",
        "first_name": "JANET",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "25631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1273037",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.