Active NPI
Great River Women'S Health
- Obstetrics & Gynecology Physician
- West Burlington, IA
National Provider Identifier
1902866478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- Legal business name
- GREAT RIVER WOMEN'S HEALTH
- Practice address
- 1223 S Gear Ave
Ste 208
West Burlington, IA 52655-1682 - Phone
- (319) 752-4541
- Fax
- (319) 752-4541
- NPI assigned
- Mar 27, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lisa A Bauer, CMA
- Title
- Insurance MGR
- Phone
- (319) 752-4541
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | Primary |
Addresses
Primary practice location
1223 S Gear Ave
Ste 208
West Burlington, IA 52655-1682
Mailing address
1223 S Gear Ave
Ste 208
West Burlington, IA 52655-1682
Phone (319) 752-4541
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51133 | Other | IA | WELLMARK BCBS |
| 0123299 | Medicaid | IA |
National Provider Directory
National Provider DirectoryLocations
1603 Morgan St
Ste 2
Keokuk, IA 52632
Phone (319) 524-6274
1223 S Gear Ave
Ste 208
West Burlington, IA 52655
Phone (319) 752-4541
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Obstetrics & Gynecology Physician
- West Burlington, IA
- NPI 1225099302
-
- Obstetrics & Gynecology Physician
- West Burlington, IA
- NPI 1366402810
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143417600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1902866478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1223 S GEAR AVE",
"address_2": "STE 208",
"city": "WEST BURLINGTON",
"state": "IA",
"postal_code": "526551682",
"telephone_number": "319-752-4541",
"fax_number": "319-752-4541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1223 S GEAR AVE",
"address_2": "STE 208",
"city": "WEST BURLINGTON",
"state": "IA",
"postal_code": "526551682",
"telephone_number": "319-752-4541",
"fax_number": "319-752-4541"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GREAT RIVER WOMEN'S HEALTH",
"organizational_subpart": "NO",
"enumeration_date": "2006-03-27",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "BAUER",
"authorized_official_first_name": "LISA",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "INSURANCE MGR",
"authorized_official_telephone_number": "319-752-4541",
"authorized_official_credential": "CMA"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BCBS",
"identifier": "51133",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0123299",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in West Burlington, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.