NPIMap

Organization Active NPI

Grand View University

Doing business as Grand View Health Services

  • Pediatric Adolescent Medicine Physician
  • Des Moine, IA
National Provider Identifier
1861908089
Registry record updated Dec 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
23873 Issued in IA
Legal business name
GRAND VIEW UNIVERSITY
Doing business as
Grand View Health Services
Practice address
1200 Grandview Ave
Johnson Wellness Center
Des Moine, IA 50316-1529
Phone
(972) 367-4845
NPI assigned
Dec 26, 2017
Last updated
Dec 26, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2017

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

Authorized official

Name
Mouzon Bass III
Title
Agent
Phone
(972) 367-4845

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 23873 IA Primary

Addresses

Primary practice location

1200 Grandview Ave
Johnson Wellness Center
Des Moine, IA 50316-1529

Mailing address

5050 Spring Valley Rd
Dallas, TX 75244-3995

Other names 1

  • Grand View Health Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Grand View Health Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1200 Grandview Ave
Des Moines, IA 50316
Phone (515) 263-2871

NPI Registry JSON

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

{
    "created_epoch": "1514246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514246400000",
    "number": "1861908089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 SPRING VALLEY RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 GRANDVIEW AVE",
            "address_2": "JOHNSON WELLNESS CENTER",
            "city": "DES MOINE",
            "state": "IA",
            "postal_code": "503161529",
            "telephone_number": "972-367-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND VIEW UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-26",
        "last_updated": "2017-12-26",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "MOUZON",
        "authorized_official_title_or_position": "AGENT",
        "authorized_official_telephone_number": "972-367-4845",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "IA",
            "license": "23873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand View Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2017; 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.