Grinnell Regional Medical Center

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

GRINNELL REGIONAL MEDICAL CENTER

Practice address

709 2ND St
Victor, IA 52347-7709

Phone

(319) 647-7511

Fax

(319) 647-7521

NPI assigned

Nov 27, 2006

Organization subpart

Yes

Parent organization

GRINNELL REGIONAL MEDICAL CENTERAs reported in NPPES

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

Authorized official

Name

Mr. Kyle M Wilcox

Title

Cfo

Phone

(641) 236-2919

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• VICTOR HEALTH CENTER Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Part of

Lynnville Medical Clini

Locations

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Marengo Memorial Hospital

  • Rural Health Clinic/Center
  • Victor, IA
  • NPI 1679246722

  Sold to, 2021-09-01

  CMS change of ownership

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Aaron Lee Anderson, PA-C

  • Physician Assistant
  • Ankeny, IA
  • NPI 1780769323
  NPD (past)
• Rebecca Anne Dillman, PA-C

  • Physician Assistant
  • West Des Moines, IA
  • NPI 1780814707
  NPD (past)
• Stacy Kuiper, ARNP

  • Nurse Practitioner
  • West Des Moines, IA
  • NPI 1336764182
  NPD (past)
• Joseph Whitman, DO

  • Otolaryngology Physician
  • Grinnell, IA
  • NPI 1336548346
  NPD (past)
• Kirk Lane Smith, MD

  • Internal Medicine Physician
  • Brownsville, TX
  • NPI 1497125215
  NPD (past)

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515801600000",
    "number": "1720154263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 2ND ST",
            "city": "VICTOR",
            "state": "IA",
            "postal_code": "523477709",
            "telephone_number": "319-647-7511",
            "fax_number": "319-647-7521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 2ND ST",
            "city": "VICTOR",
            "state": "IA",
            "postal_code": "523477709",
            "telephone_number": "319-647-7511",
            "fax_number": "319-647-7521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRINNELL REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRINNELL REGIONAL MEDICAL CENTER",
        "enumeration_date": "2006-11-27",
        "last_updated": "2018-01-13",
        "status": "A",
        "authorized_official_last_name": "WILCOX",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "641-236-2919",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0685107",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VICTOR HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• H-L-V CSD
• HLV Community School District
• Hy-Vee Inc
• Marengo Memorial Hospital
• MCLD Corporation

• All providers in Victor, IA
• Rural Health Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.