NPIMap

Organization Active NPI

Prairie City Family Clinic

  • Primary Care Clinic/Center
  • Bondurant, IA
National Provider Identifier
1902269632
Registry record updated Mar 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
A133377 Issued in IA
Legal business name
PRAIRIE CITY FAMILY CLINIC
Practice address
1316 Joshua CT SE
Bondurant, IA 50035-4700
Phone
(515) 249-5775
NPI assigned
Mar 31, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2016

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

Authorized official

Name
Lisa SytsmaNPI 1770937682
Title
Arnp
Phone
(515) 249-5775

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X A133377 IA Primary

Addresses

Primary practice location

1316 Joshua CT SE
Bondurant, IA 50035-4700

Mailing address

1316 Joshua CT SE
Bondurant, IA 50035-4700
Phone (515) 249-5775

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1459382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459382400000",
    "number": "1902269632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 JOSHUA CT SE",
            "city": "BONDURANT",
            "state": "IA",
            "postal_code": "500354700",
            "telephone_number": "515-249-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 JOSHUA CT SE",
            "city": "BONDURANT",
            "state": "IA",
            "postal_code": "500354700",
            "telephone_number": "515-249-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE CITY FAMILY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-31",
        "last_updated": "2016-03-31",
        "status": "A",
        "authorized_official_last_name": "SYTSMA",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "ARNP",
        "authorized_official_telephone_number": "515-249-5775"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IA",
            "license": "A133377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bondurant, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; 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.