Charles Everett Grado, M.D.

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

24782 Issued in IA

Practice address

3705 River Ridge Dr NE
Cedar Rapids, IA 52402-7596

Phone

(319) 393-1902

Fax

(319) 393-1867

NPI assigned

Aug 9, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Plastic Surgical Center

  • Plastic Surgery Physician
  • Cedar Rapids, IA
  • NPI 1285722264
  NPD (past) Authorized official

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448928000000",
    "number": "1710988217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 RIVER RIDGE DR NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524027596",
            "telephone_number": "319-393-1902",
            "fax_number": "319-393-1867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 RIVER RIDGE DR NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524027596",
            "telephone_number": "319-393-1902",
            "fax_number": "319-393-1867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRADO",
        "first_name": "CHARLES",
        "middle_name": "EVERETT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2015-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "IA",
            "license": "24782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0229138",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Plastic and Reconstructive Surgery Physician in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Plastic and Reconstructive Surgery Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.