Individual provider Active NPI

Kathleen A.N. Grauerholz, MD

  • Family Medicine Physician
  • Cedar Falls, IA
National Provider Identifier
1760410013
Registry record updated Jul 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
26790 Issued in IA
Practice address
226 Bluebell Rd
Cedar Falls, IA 50613-6328
Phone
(319) 575-5800
NPI assigned
Jun 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2007

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 26790 IA Primary

Addresses

Primary practice location

226 Bluebell Rd
Cedar Falls, IA 50613-6328

Mailing address

2101 Kimball Ave
LL14
Waterloo, IA 50702-5063
Phone (319) 272-1590

Other identifiers 1

IdentifierTypeStateIssuer
1043620MedicaidIA

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

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184284800000",
    "number": "1760410013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 KIMBALL AVE",
            "address_2": "LL14",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025063",
            "telephone_number": "319-272-1590",
            "fax_number": "319-272-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 BLUEBELL RD",
            "city": "CEDAR FALLS",
            "state": "IA",
            "postal_code": "506136328",
            "telephone_number": "319-575-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAUERHOLZ",
        "first_name": "KATHLEEN",
        "middle_name": "A.N.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "26790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043620",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Falls, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; 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.