Grace Breast Imaging & Medical Spa PLLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

GRACE BREAST IMAGING & MEDICAL SPA PLLC

Practice address

1250 NW 128TH St Ste 130
Clive, IA 50325-7433

Phone

(515) 505-3224

NPI assigned

Jun 4, 2024

Last updated

Jun 5, 2024By 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

Andrea LamphiearNPI 1982892220

Title

Member

Phone

(515) 505-3224

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Locations

Practitioners 2

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.

• Andrea G. Lamphiear, M.D.

  • Diagnostic Radiology Physician
  • Council Bluffs, IA
  • NPI 1982892220
  Medicare reassignment Care Compare group NPD Authorized official
• Rachel Ann Berger Preisser, M.D.

  • Diagnostic Radiology Physician
  • Clive, IA
  • NPI 1487813903
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717545600000",
    "number": "1568203487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 NW 128TH ST STE 130",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503257433",
            "telephone_number": "515-505-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 NW 128TH ST STE 130",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503257433",
            "telephone_number": "515-505-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE BREAST IMAGING & MEDICAL SPA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A",
        "authorized_official_last_name": "LAMPHIEAR",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "515-505-3224"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Goetz, MA
• Golden Age Caregivers
• Matthew Robert Golish, M.D.
• Good Company Counseling and Consulting LTD
• Andrew Robert Goodrich, FPMHNP-BC
• Tara Michelle Graff, DO
• Jason Michael Graham, ATC, LAT
• Lindsey Lea Grandbois, D.O.
• Yim Lae Graner
• Stephen Bernard Grant, MD

• Radiology Clinic/Center in Clive, IA
• Providers in Clive, IA by specialty
• Radiology Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.