Individual provider Active NPI

Corrine M Ganske, MD

  • Family Medicine Physician
  • Des Moines, IA
National Provider Identifier
1710947346
Registry record updated Mar 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD-24154 Issued in IA
Practice address
840 E University Ave
Des Moines, IA 50316-2304
Phone
(515) 265-4211
Fax
(515) 309-5993
NPI assigned
Mar 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD-24154 IA Primary

Addresses

Primary practice location

840 E University Ave
Des Moines, IA 50316-2304

Mailing address

840 E University Ave
Des Moines, IA 50316-2304
Phone (515) 265-4211

Other identifiers 2

IdentifierTypeStateIssuer
1710947346MedicaidIA
0218065MedicaidIA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD-24154IAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426032000000",
    "number": "1710947346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 E UNIVERSITY AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503162304",
            "telephone_number": "515-265-4211",
            "fax_number": "515-309-5993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 E UNIVERSITY AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503162304",
            "telephone_number": "515-265-4211",
            "fax_number": "515-309-5993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANSKE",
        "first_name": "CORRINE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-27",
        "last_updated": "2015-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "MD-24154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710947346",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0218065",
            "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 Mar 11, 2015; 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.