Organization Active NPI

Grinnell Family Care PC

  • Family Medicine Physician
  • Grinnell, IA
National Provider Identifier
1972617611
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GRINNELL FAMILY CARE PC
Practice address
217 4TH Ave W
Grinnell, IA 50112-1895
Phone
(641) 236-7524
Fax
(641) 236-7944
NPI assigned
Aug 19, 2006
Last updated
Oct 11, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Authorized official

Name
Lynnda Risting
Title
Office Manager
Phone
(641) 236-7524

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

217 4TH Ave W
Grinnell, IA 50112-1895

Mailing address

217 4TH Ave W
Grinnell, IA 50112-1895
Phone (641) 236-7524

Other identifiers 1

IdentifierTypeStateIssuer
0120006MedicaidIA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192060800000",
    "number": "1972617611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 4TH AVE W",
            "city": "GRINNELL",
            "state": "IA",
            "postal_code": "501121895",
            "telephone_number": "641-236-7524",
            "fax_number": "641-236-7944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 4TH AVE W",
            "city": "GRINNELL",
            "state": "IA",
            "postal_code": "501121895",
            "telephone_number": "641-236-7524",
            "fax_number": "641-236-7944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRINNELL FAMILY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-10-11",
        "status": "A",
        "authorized_official_last_name": "RISTING",
        "authorized_official_first_name": "LYNNDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "641-236-7524"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0120006",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grinnell, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; 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.