Physicians Clinic, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PHYSICIANS CLINIC, INC.

Doing business as

Methodist Physicians Clinic

Practice address

1400 Senate Ave
Suite # 105
Red Oak, IA 51566-1271

Phone

(712) 623-7250

Fax

(712) 623-7257

NPI assigned

Jul 10, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Todd D. Grages

Title

President

Phone

(402) 354-5601

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Methodist Physicians Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Physicians Clinic Inc

  dba Methodist Physicians Clinic

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1821049156

  O20040129000296

  Same enrollment

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942408117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8601 W DODGE RD",
            "address_2": "SUITE # 216",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143457",
            "telephone_number": "402-354-4822",
            "fax_number": "402-354-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 SENATE AVE",
            "address_2": "SUITE # 105",
            "city": "RED OAK",
            "state": "IA",
            "postal_code": "515661271",
            "telephone_number": "712-623-7250",
            "fax_number": "712-623-7257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRAGES",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-354-5601",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-IA",
            "identifier": "42585",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0415257",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Methodist Physicians Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Josie Clare Partridge, PHARMD, RPH
• Renjason C Patulot, MA
• Eric L Paulson, MD
• Magnum Peterson, EDS
• Physicians Clinic, Inc. (Methodist Physicians Clinic)
• Debbie L Pierson
• Edward Piller, MD
• Marcela Ivette Pineda Molina, MD
• Beverly Pippin, PTA
• Planned Parenthood of the Heartland

• Family Medicine Physician in Red Oak, IA
• Providers in Red Oak, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.