EMAN BOULIS (NPI# 1265617047) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265617047 |
| Entity Type | Individual |
| Full Name | EMAN BOULIS |
| Credential | MD |
| Practice Address |
210 4th Ave Grinnell IA 50112-1898 |
| Practice Telephone | 6412367511 |
| Practice Fax Number | 6412362058 |
| Mailing Telephone | 6412367511 |
| Mailing Fax Number | 6412362058 |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2014-11-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | MD433023 | PA | Allopathic & Osteopathic Physicians |
| N | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
MD-41825 | IA | Allopathic & Osteopathic Physicians |
| Y | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
20150 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | IA CSA | 1246481 | 01 |
| PA | 102065830 | 05 | |
| IA | IA LICENSE | MD-41825 | 01 |
| IA | DEA | FB0592635 | 01 |
| Street Address |
210 4TH AVE |
| City | GRINNELL |
| State | IA |
| Zip Code | 50112-1898 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417941717 | Patrick J Cogley | Family Medicine | 210 4th Ave, Grinnell, IA 50112-0780 | 2005-09-01 |
| 1609494673 | Des Moines Orthopaedic Surgeons PC | Durable Medical Equipment & Medical Supplies | 210 4th Ave, Grinnell, IA 50112-1898 | 2020-07-07 |
| 1720574692 | Elizabeth A Clancy | Occupational Therapy Assistant | 210 4th Ave, Grinnell, IA 50112-1898 | 2018-07-03 |
| 1427558857 | Lynn Marie Moorman | Nurse Practitioner | 210 4th Ave, Grinnell, IA 50112-1898 | 2018-02-12 |
| 1437663242 | Grinnell Regional Medical Center | Internal Medicine | 210 4th Ave, Grinnell, IA 50112-1898 | 2017-12-01 |
| 1508215013 | Katelyn Sue Beyer | Physician Assistant | 210 4th Ave, Grinnell, IA 50112-1898 | 2016-06-06 |
| 1639567910 | Grinnell Regional Medical Center | Obstetrics & Gynecology | 210 4th Ave, Grinnell, IA 50112-1898 | 2015-01-08 |
| 1407252372 | Grinnell Regional Medical Center | Nurse Practitioner | 210 4th Ave, Grinnell, IA 50112-1898 | 2014-11-05 |
| 1215339569 | Grinnell Regional Medical Center | Internal Medicine | 210 4th Ave, 2nd Floor Mab, Grinnell, IA 50112-1898 | 2014-09-18 |
| 1790115582 | Grinnell Regional Medical Center | Internal Medicine | 210 4th Ave, Grinnell, IA 50112-1898 | 2013-11-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912451642 | Renfrow Senior Care | Internal Medicine | 120 W. St., Grinnell, IA 50112 | 2016-08-11 |
| 1114324605 | Grinnell Health Care Center, LLC | Skilled Nursing Facility | 415 S 6th Street, Grinnell, IA 50112 | 2014-11-26 |
| 1972907061 | Katie M Little | Counselor | 821 5th Ave Ste 401, Grinnell, IA 50112 | 2014-10-17 |
| 1366606287 | Kara Collings | Optometrist | 619 6th Ave, Grinnell, IA 50112 | 2008-07-10 |
| 1053510123 | Jennifer Davis | Speech-Language Pathologist | 79 Sixth Ave, Grinnell, IA 50112 | 2007-07-17 |
| 1306059506 | Grinnell Regional Medical Center, Inc | Anesthesiology | 210 Fourth Avenue, Grinnell, IA 50112 | 2007-05-07 |
| 1609906510 | Poweshiek County Case Management | Case Management | 120 W. Street, Grinnell, IA 50112 | 2007-03-07 |
| 1982756284 | The Grinnell Institute for Bone Health | Orthopaedic Surgery | 810 Commercial St., Grinnell, IA 50112 | 2007-01-17 |
| 1689771412 | Brandon L Davis | Psychologist | 200 4th Ave West, Grinnell, IA 50112 | 2006-09-20 |
| 1740240456 | Beth Mi Gallegos | Social Worker | 807 4th, Grinnell, IA 50112 | 2006-03-25 |
| Find all providers in zip 50112 | ||||
| Taxonomy Code | 207RR0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Rheumatology |
| An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215339569 | Grinnell Regional Medical Center | Internal Medicine | 210 4th Ave, 2nd Floor Mab, Grinnell, IA 50112-1898 | 2014-09-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588701205 | Cnos PC | Internal Medicine | 4802 Sunnybrook Dr, Sioux City, IA 51106-4233 | 2007-01-31 |
| 1255319422 | David B Staub | Internal Medicine | 3740 Utica Ridge Rd Ste A, Bettendorf, IA 52722-1624 | 2006-01-06 |
| 1336501279 | Mercy Professional Practice Associates Inc | Internal Medicine | 300 N 4th Ave E, Suite C2, Newton, IA 50208-3155 | 2016-03-21 |
| 1720462914 | Iowa Arthritis and Osteoporosis Center PC | Internal Medicine | 8421 Plum Dr, Urbandale, IA 50322-7356 | 2015-07-17 |
| 1407029721 | Theodore W Rooney | Internal Medicine | 8421 Plum Dr, Des Moines, IA 50322-7356 | 2008-04-08 |
| 1851578868 | Rheumatology Associates, PC | Internal Medicine | 3740 Utica Ridge Rd, Bettendorf, IA 52722-1624 | 2008-01-22 |
| 1043407562 | Dubuque Rheumatology, P.C. | Internal Medicine | 2140 Jfk Rd, Suite B, Dubuque, IA 52002-3883 | 2007-09-28 |
| 1790975811 | Rheumatology Care, LLC | Internal Medicine | 3385 Dexter Ct, Suite 103, Davenport, IA 52807-3471 | 2007-07-25 |
| 1407065006 | Sunita Kammila Penmatcha | Internal Medicine | 3740 Utica Ridge Rd, Bettendorf, IA 52722-1624 | 2007-05-21 |
| 1134249832 | Steven Michael Craig | Internal Medicine | 8421 Plum Dr, Des Moines, IA 50322-7356 | 2007-03-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.