NPIMap

Organization Active NPI

State University of Iowa

Doing business as University of Iowa Health Care Medical Center-Grinnell Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Grinnell, IA
National Provider Identifier
1881679371
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
STATE UNIVERSITY OF IOWA
Doing business as
University of Iowa Health Care Medical Center-Grinnell Dialysis Center
University of Iowa Hospitals & Clinics-Grinnell Dialysis Center
Practice address
803 Broad St
Grinnell, IA 50112-2153
Phone
(641) 236-7419
NPI assigned
Dec 7, 2005
Last updated
Apr 24, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
STATE UNIVERSITY OF IOWAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Authorized official

Name
Mr. Joe M McKelvey Jr.
Title
Sr Director of Government Reimb
Phone
(319) 467-8549

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

803 Broad St
Grinnell, IA 50112-2153

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
0600585MedicaidIA
62306OtherIAWELLMARK BCBS

Other names 2

  • University of Iowa Health Care Medical Center-Grinnell Dialysis Center Doing business as
  • University of Iowa Hospitals & Clinics-Grinnell Dialysis Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20021007000013 IA Part A Provider - End-Stage Renal Disease Facility (ESRD) 7618884230 Practice locations: Grinnell, IA
O20031107000060 IA Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 2,348 practitioners
37 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs with the same Medicare PAC ID 20

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 20

Other NPIs on the same Medicare enrollment 36

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 36

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
University of Iowa Hospital & Clinics - GrinnellCCN 163507
Ownership
Non-profit
Certified
Jul 28, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Dialysis stations
9

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

National Provider Directory

National Provider Directory
Tax ID family
Univ of Ia Hosps Clins57 organizations share this tax ID, including this one
Part of
Univ of Ia Hosps Clins

Organizations with this tax ID in the same state 17

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 17

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
University of Iowa Health Care Medical CenterIowa City, IA, CCN 160058 Hospital Other Jul 1, 1966
University of Iowa Health Care Medical CenterIowa City, IA, CCN 16S058 Hospital Other Jul 1, 1966
University of Iowa Health Care Medical Center DowntownIowa City, IA, CCN 160029 Hospital Other Jan 31, 2024
University of Iowa Health Care Medical Center Downtown Home HealthCoralville, IA, CCN 167181 Home health agency Other Jan 31, 2024

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713916800000",
    "number": "1881679371",
    "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": "319-356-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 BROAD ST",
            "city": "GRINNELL",
            "state": "IA",
            "postal_code": "501122153",
            "telephone_number": "641-236-7419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE UNIVERSITY OF IOWA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE UNIVERSITY OF IOWA",
        "enumeration_date": "2005-12-07",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A",
        "authorized_official_last_name": "MCKELVEY",
        "authorized_official_first_name": "JOE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SR DIRECTOR OF GOVERNMENT REIMB",
        "authorized_official_telephone_number": "319-467-8549",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0600585",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "62306",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University of Iowa Health Care Medical Center-Grinnell Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "University of Iowa Hospitals & Clinics-Grinnell Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grinnell, IA

Sources for this page

Verify at the official NPI Registry.