CRESTON MEDICAL CLINIC P.C. NPI 1740232842

NPI Information

NPI: 1740232842
Provider Name: CRESTON MEDICAL CLINIC, P.C.
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
1610 W TOWNLINE ST
SUITE 200
CRESTON, IA
ZIP 50801
Phone: (641) 782-2131
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CRESTON MEDICAL CLINIC, P.C. is a family medicine in Creston, IA. The provider is 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. CRESTON MEDICAL CLINIC, P.C. NPI is 1740232842. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1610 W TOWNLINE ST
SUITE 200
CRESTON, IA
ZIP 50801-066
Phone: (641) 782-2131
Fax: (641) 782-6425

The provider's authorized official is James E Mansour .
The authorized official title is President Of The Corporation and has the following contact phone number (641) 782-2131.

The enumeration date for this NPI number is 5/17/2006 and was last updated on 10/2/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208600000X	Surgery				No
2	207Q00000X	Family Medicine				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	C54555	OTHER	IOWA	RAILROAD GROUP BILLING #
2	01353	OTHER	IOWA	WELLMARK BCBS GROUP #
3	01353	OTHER	IOWA	WELLMARK BCBS #
4	0013532	MEDICAID	IOWA
5	01353	MEDICARE ID-TYPE UNSPECIFIED		GROUP BILLING NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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