NPIMap

Organization Active NPI

Gary Volentine MD

  • Gastroenterology Physician
  • Council Bluffs, IA
National Provider Identifier
1861551665
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
21611 Issued in IA
Legal business name
GARY VOLENTINE MD
Practice address
801 Harmony St
Suite 404
Council Bluffs, IA 51503-3106
Phone
(712) 322-2332
Fax
(712) 322-5122
NPI assigned
Dec 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Authorized official

Name
Miss Tammy K Colegrove, ARNPNPI 1932106044
Title
Arnp
Phone
(712) 322-2332

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RG0100X 21611 IA Primary
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X 107489 IA

Addresses

Primary practice location

801 Harmony St
Suite 404
Council Bluffs, IA 51503-3106

Mailing address

801 Harmony St
Suite 404
Council Bluffs, IA 51503-3106
Phone (712) 322-2332

Other identifiers 1

IdentifierTypeStateIssuer
3941278MedicaidIA

National Provider Directory

National Provider Directory

Locations

801 Harmony St
Ste 404
Council Bluffs, IA 51503
Phone (712) 322-2332

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1165449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1861551665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 HARMONY ST",
            "address_2": "SUITE 404",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515033106",
            "telephone_number": "712-322-2332",
            "fax_number": "712-322-5122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 HARMONY ST",
            "address_2": "SUITE 404",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515033106",
            "telephone_number": "712-322-2332",
            "fax_number": "712-322-5122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY VOLENTINE MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-07",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "COLEGROVE",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "ARNP",
        "authorized_official_telephone_number": "712-322-2332",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IA",
            "license": "21611",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "107489",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3941278",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.