Individual provider Active NPI

Chanda Nicole Gritters, PA-C

  • Physician Assistant
  • Iowa City, IA
National Provider Identifier
1851177240
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
121038 Issued in IA
Practice address
269 N 1St Ave
Iowa City, IA 52245-3645
Phone
(319) 351-6852
Fax
(319) 351-2625
NPI assigned
Sep 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 121038 IA Primary

Addresses

Primary practice location

269 N 1St Ave
Iowa City, IA 52245-3645

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 351-6852

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240215002100 IA Practitioner - Physician Assistant 1557705753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Progressive Rehabilitation Associates LLCGroup PAC ID 2961443072, 275 clinicians
State University of IowaGroup PAC ID 7618884230, 1,886 clinicians

Practice addresses (Care Compare)

1130 S Scott Blvd
Suite 1
Iowa City, IA 52240-2909
Phone (319) 354-2429

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-1616

Hospital & facility affiliations

  • University of Iowa Hospital & Clinics Hospital, Iowa City, IA, CCN 160058
  • University of Iowa Health Care Medical Center Down Hospital, Iowa City, IA, CCN 160029

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
121038IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
State University of Iowa CurrentSince Jan 31, 2024 Accepting new patients
State University of Iowa CurrentSince Jan 31, 2024 Accepting new patients
State University of Iowa Past Accepting new patients

Locations

200 Hawkins Dr
Iowa City, IA 52242
Phone (319) 356-1616

200 Hawkins Dr
#H
Iowa City, IA 52242
Phone (319) 356-1616

269 N 1st Ave
Iowa City, IA 52245
Phone (319) 339-3541

500 E Market St
Iowa City, IA 52245
Phone (319) 339-0300

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1693526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1851177240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-351-6852",
            "fax_number": "319-351-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 N 1ST AVE",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522453645",
            "telephone_number": "319-351-6852",
            "fax_number": "319-351-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRITTERS",
        "first_name": "CHANDA",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-01",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "121038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.