Cedar Valley Medical Specialists PC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

CEDAR VALLEY MEDICAL SPECIALISTS PC

Doing business as

West Union Dialysis Center

Practice address

405 Highway 150 N
West Union, IA 52175-1003

Phone

(563) 422-5734

Fax

(563) 422-5830

NPI assigned

May 20, 2006

Last updated

Apr 20, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

CEDAR VALLEY MEDICAL SPECIALISTS PCAs reported in NPPES

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

Authorized official

Name

Gilmore John Irey

Title

Ceo

Phone

(319) 235-5390

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• West Union Dialysis Center Doing business as

Part of

Cedar Valley Med Spec PC

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Cedar Valley Medical Specialists, PC

  dba Ortho Surgery Dept/ Grundy

  • Durable Medical Equipment & Medical Supplies
  • Grundy Center, IA
  • NPI 1609127737

  Member Of

  NPD member

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1821042318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2758",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507042758",
            "telephone_number": "563-422-5734",
            "fax_number": "563-422-5830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 HIGHWAY 150 N",
            "city": "WEST UNION",
            "state": "IA",
            "postal_code": "521751003",
            "telephone_number": "563-422-5734",
            "fax_number": "563-422-5830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR VALLEY MEDICAL SPECIALISTS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CEDAR VALLEY MEDICAL SPECIALISTS PC",
        "enumeration_date": "2006-05-20",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "IREY",
        "authorized_official_first_name": "GILMORE",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "319-235-5390"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "62526",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0625269",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Union Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lew D. Bishop, AUD
• Jaclyn Marie Bormann, LPT
• Kyle Brandt
• Melinda Sue Brokaw, CNP ARNP
• Patricia Carey, DPT
• Alyssa Cobie-Nuss, TLMHC
• Darcy H Connelly, PA
• Copper Creek SL LLC
• Carina Crookston, MD
• Dawn Ann Daughton, M.T.P.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in West Union, IA
• Providers in West Union, IA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.