Chariton Valley Medical Center PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01603 Issued in IA

Legal business name

CHARITON VALLEY MEDICAL CENTER PC

Practice address

707 S Main
Centerville, IA 52544-2421

Phone

(641) 437-4344

Fax

(641) 856-5410

NPI assigned

Apr 6, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Stephen S Jewett, MD

Title

Owner

Phone

(641) 437-4344

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kathleen A Lange, M.D.

  • Family Medicine Physician
  • Centerville, IA
  • NPI 1811085848
  Medicare reassignment NPD

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902868664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "address_2": "707 S MAIN",
            "city": "CENTERVILLE",
            "state": "IA",
            "postal_code": "525442421",
            "telephone_number": "641-437-4344",
            "fax_number": "641-856-5410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S MAIN",
            "city": "CENTERVILLE",
            "state": "IA",
            "postal_code": "525442421",
            "telephone_number": "641-437-4344",
            "fax_number": "641-856-5410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARITON VALLEY MEDICAL CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JEWETT",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "641-437-4344",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "17554",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "30574",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "01603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3130443",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0024141",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1110031",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catholic Health Initiatives - Iowa Corp
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• Center for Behavioral Services
• Centerville Community Betterment Inc Zylpha Price House
• Centerville CSD
• City of Centerville
• Brooke L Comer, DPT, LAT, ATC
• Amanda Condra, ARNP
• Cornerstone Counseling Center
• Cornerstone Counseling Center

• Family Medicine Physician in Centerville, IA
• Providers in Centerville, IA by specialty
• Family Medicine Physician in Iowa

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.