Derek Groathouse, RD
Individual provider Active NPI Registered Dietitian · Grimes, IA
NPI 1881463370 · NPPES record last updated Dec 26, 2023
Key facts
- NPI
- 1881463370
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 121584 (IA)
- Practice address
- 3801 S James St Ste 400
Grimes, IA 50111-5167 - Phone
- (515) 695-3767
- NPI assigned
- Dec 26, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240506000251 | IA | Practitioner - Registered Dietitian Or Nutrition Professional | 5698115863 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Belmond Community Hospital | Current |
Accepting new patients | |
| Iowa Specialty Hospital- Clarion | Current |
Accepting new patients | |
| Iowa Specialty Hospital- Clarion | Past | Accepting new patients | |
| Iowa Specialty Hospital- Clarion | Past | Accepting new patients | |
| Belmond Community Hospital | Past | Accepting new patients |
Locations
1111 Duff Ave
Ste 2607
Ames, IA 50010
Phone (515) 327-2000
403 1st St SE
Belmond, IA 50421
Phone (641) 444-3223
215 13th Ave SW
Clarion, IA 50525
Phone (515) 532-2836
1316 S Main St
Clarion, IA 50525
Phone (515) 532-2811
5901 Thornton Ave
Ste 101
Des Moines, IA 50321
Phone (515) 327-2000
5901 Thornton Ave
Des Moines, IA 50321
Phone (515) 327-2000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 121584 | IA | Yes |
Addresses
Primary practice location
3801 S James St Ste 400
Grimes, IA 50111-5167
Mailing address
3515 S Duff Ave
Ames, IA 50010-8504
Phone (515) 480-8761
Other providers in Grimes, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.