NPIMap

Organization Active NPI

Grapevine Clinical LLC

  • Clinical Social Worker
  • West Des Moines, IA
National Provider Identifier
1952837809
Registry record updated Feb 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
007572 Issued in IA
Legal business name
GRAPEVINE CLINICAL LLC
Practice address
4949 Pleasant St Ste 104
West Des Moines, IA 50266-5494
Phone
(515) 369-0034
Fax
(844) 381-0919
NPI assigned
May 11, 2017
Last updated
Feb 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2026

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

Authorized official

Name
Wendy TillgrenNPI 1245533348
Title
Partner
Phone
(515) 369-0034

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
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 007572 IA Primary

Addresses

Primary practice location

4949 Pleasant St Ste 104
West Des Moines, IA 50266-5494

Mailing address

4949 Pleasant St Ste 104
West Des Moines, IA 50266-5494
Phone (515) 369-0034

Other practice location 1

666 Walnut St Ste 1610
Des Moines, IA 50309-3974
Phone (515) 360-0034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170912003283 IA Part B Supplier - Clinic/Group Practice 5294008397 Receives reassigned benefits from 1 practitioner
Practice locations: West Des Moines, IA

National Provider Directory

National Provider Directory

Locations

431 28th St
Ste 205
Des Moines, IA 50312
Phone (515) 241-4447

606 Walnut St
Ste 1610
Des Moines, IA 50309
Phone (515) 360-0034

4949 Pleasant St
Ste 104
West Des Moines, IA 50266
Phone (515) 364-0034

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25392/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770940800000",
    "number": "1952837809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4949 PLEASANT ST STE 104",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665494",
            "telephone_number": "515-369-0034",
            "fax_number": "844-381-0919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4949 PLEASANT ST STE 104",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665494",
            "telephone_number": "515-369-0034",
            "fax_number": "844-381-0919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "666 Walnut St Ste 1610",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503093974",
            "country_code": "US",
            "telephone_number": "515-360-0034",
            "fax_number": "844-381-0919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GRAPEVINE CLINICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A",
        "authorized_official_last_name": "TILLGREN",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "515-369-0034"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "007572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2026; 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.