Great River Community Medical Clinic SC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

23439 Issued in WI

Legal business name

GREAT RIVER COMMUNITY MEDICAL CLINIC SC

Practice address

100 N Marquette Rd
Suite 106
Prairie Du Chien, WI 53821

Phone

(608) 326-1072

Fax

(608) 326-1076

NPI assigned

May 30, 2008

Last updated

Oct 6, 2008By 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

Mark A Grunwald, MDNPI 1336144914

Title

President

Phone

(608) 326-5459

Specialties & licenses 2

Addresses

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.

• Mark A Grunwald, MD

  • Family Medicine Physician
  • Prairie Du Chien, WI
  • NPI 1336144914
  Authorized official Same address or phone
• Ann L Grunwald, MD

  • Family Medicine Physician
  • Prairie Du Chien, WI
  • NPI 1174528756
  NPD (past)

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223251200000",
    "number": "1659539203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N MARQUETTE RD",
            "address_2": "SUITE 106",
            "city": "PRAIRIE DU CHIEN",
            "state": "WI",
            "postal_code": "53821",
            "telephone_number": "608-326-1072",
            "fax_number": "608-326-1076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MARQUETTE RD",
            "address_2": "SUITE 106",
            "city": "PRAIRIE DU CHIEN",
            "state": "WI",
            "postal_code": "53821",
            "telephone_number": "608-326-1072",
            "fax_number": "608-326-1076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT RIVER COMMUNITY MEDICAL CLINIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-30",
        "last_updated": "2008-10-06",
        "status": "A",
        "authorized_official_last_name": "GRUNWALD",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "608-326-5459",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "23379",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "23439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn K Gilman, LCSW, SAC-IT
• Katelyn Marie Goodney
• Sandy Z. Goree, R.D.
• Penny K Grassel, LAT
• Great River Community Medical Center, SC
• Erin M Greenya
• Ann L Grunwald, MD
• Mark A Grunwald, MD
• Gundersen Clinic LTD (Gundersen Pharmacy)
• Gundersen Clinic, LTD. (Gundersen Eye Clinic and Dental Specialties Prairie du Chien)

• Family Medicine Physician in Prairie Du Chien, WI
• Providers in Prairie Du Chien, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2008; 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.