GREAT RIVER MEDICAL SERVICES (NPI# 1417025230) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417025230 |
| Entity Type | Organization |
| Organization Name | GREAT RIVER MEDICAL SERVICES |
| Other Organization Name | BURLINGTON AREA FAMILY PRACTICE CENTER |
| Practice Address |
1201 W Agency Rd West Burlington IA 52655-1645 |
| Practice Telephone | 3197544242 |
| Practice Fax Number | 3197544079 |
| Mailing Telephone | 3197544242 |
| Mailing Fax Number | 3197544079 |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2007-10-09 |
| Authorized Official Name | MR. ROBERT S POETTING (ADMINISTRATOR) |
| Authorized Official Telephone | 3197544242 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0198473 | 05 |
| Other Name | Type Code |
|---|---|
| Burlington Area Family Practice Center | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | GREAT RIVER MEDICAL SERVICES | 1221 S Gear Ave, West Burlington, IA 52655 |
| Street Address |
1201 W AGENCY RD |
| City | WEST BURLINGTON |
| State | IA |
| Zip Code | 52655-1645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922003003 | Timothy J Hunter | Family Medicine | 1201 W Agency Rd, West Burlington, IA 52655-1645 | 2005-06-16 |
| 1487137428 | Urime Mehmedi | Nurse Practitioner | 1201 W Agency Rd, West Burlington, IA 52655-1645 | 2018-09-14 |
| 1417314683 | Jennifer Lin Clark | Registered Nurse | 1201 W Agency Rd, West Burlington, IA 52655-1645 | 2016-01-19 |
| 1710379995 | Mel Davis Schiefer | Counselor | 1201 W Agency Rd, West Burlington, IA 52655-1645 | 2015-02-25 |
| 1083021372 | Nicole Ann Ferrill | Nurse Practitioner | 1201 W Agency Rd, West Burlington, IA 52655-1645 | 2014-07-18 |
| 1275953937 | Anjali Katiyar Sobti | Family Medicine | 1201 W Agency Rd, West Burlington, IA 52655-1645 | 2014-04-21 |
| 1780998450 | Maricris Enriquez Lapinid | Family Medicine | 1201 W Agency Rd, West Burlington, IA 52655-1645 | 2010-08-04 |
| 1467639179 | Kathy Ibeth Rashid | Physician Assistant | 1201 W Agency Rd, West Burlington, IA 52655-1645 | 2008-01-24 |
| 1396862579 | Michael J Baird | Psychologist | 1201 W Agency Rd, West Burlington, IA 52655-1645 | 2007-03-23 |
| 1386712149 | Thomas C Boyd | Family Medicine | 1201 W Agency Rd, West Burlington, IA 52655-1645 | 2006-12-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679920045 | Breanne Vogel | Nurse Practitioner | 1225 South Gear Avenue, Suite 159, Great River Family Practice Clinic, West Burlington, IA 52655 | 2016-05-16 |
| 1639538010 | Kala Haisch | Nurse Practitioner | 1225 S. Gear Ave., Mercy Plaza, Suite 251, West Burlington, IA 52655 | 2016-02-15 |
| 1326305830 | Ryan Deets | Surgery | 1223 S Gear Ave Ste 202, West Burlington, IA 52655 | 2012-04-20 |
| 1912100173 | Jennifer Yancey | Dietitian, Registered | Great River Medical Center Center for Rehabilitation, 1401 W. Agency Rd., West Burlington, IA 52655 | 2007-06-06 |
| 1043348196 | Wilson Hearing Aids & Services Inc | Hearing Instrument Specialist | 313 E Agency Rd, West Burlington, IA 52655 | 2007-03-01 |
| 1730286204 | Eric A Hanks | Chiropractor | 433 E Mt Pleasant St, West Burlington, IA 52655 | 2006-09-19 |
| 1093825176 | Michael Steven Mathews | Dentist | 409 Layne Dr, West Burlington, IA 52655 | 2006-08-30 |
| 1952383259 | Craig Huston | Emergency Medical Technician, Basic | 1221d S Gear Ave, West Burlington, IA 52655 | 2005-11-14 |
| 1932101466 | Theron Jameson | Specialist | 1225 S Gear Ave, Ste 159, West Burlington, IA 52655 | 2005-08-15 |
| 1255339750 | Community Health Centers of Southeastern Iowa Inc | Internal Medicine | 1706 West Agency Road, West Burlington, IA 52655 | 2005-07-08 |
| Find all providers in zip 52655 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922003003 | Timothy J Hunter | Family Medicine | 1201 W Agency Rd, West Burlington, IA 52655-1645 | 2005-06-16 |
| 1275953937 | Anjali Katiyar Sobti | Family Medicine | 1201 W Agency Rd, West Burlington, IA 52655-1645 | 2014-04-21 |
| 1780028530 | Winnie Tsao | Family Medicine | 1221 S Gear Ave, West Burlington, IA 52655-1681 | 2013-04-23 |
| 1619237849 | John Thurman | Family Medicine | 1225 S Gear Ave, Suite Number 159, West Burlington, IA 52655-1691 | 2012-05-22 |
| 1063708584 | Raj Bhui | Family Medicine | 1225 S Gear Ave, Suite 159, West Burlington, IA 52655-1691 | 2011-06-23 |
| 1780998450 | Maricris Enriquez Lapinid | Family Medicine | 1201 W Agency Rd, West Burlington, IA 52655-1645 | 2010-08-04 |
| 1386712149 | Thomas C Boyd | Family Medicine | 1201 W Agency Rd, West Burlington, IA 52655-1645 | 2006-12-01 |
| 1245308998 | William S Daft | Family Medicine | 1201 W Agency Rd, West Burlington, IA 52655-1645 | 2006-12-01 |
| 1902974652 | Robert M Hinnen | Family Medicine | 1201 W Agency Rd, West Burlington, IA 52655-1645 | 2006-12-01 |
| 1770659591 | Vincent A Taeger | Family Medicine | 1201 W Agency Rd, West Burlington, IA 52655-1645 | 2006-11-24 |
| Find all providers in WEST BURLINGTON | ||||
| City | WEST BURLINGTON |
| Zip Code | 52655 |
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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.