Organization Active NPI

Great River Women'S Health

  • Obstetrics & Gynecology Physician
  • West Burlington, IA
National Provider Identifier
1902866478
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
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

Updated by the provider on Aug 22, 2020

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)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
51133OtherIAWELLMARK BCBS
0123299MedicaidIA

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.