Individual provider Active NPI

Randall K Minion, MD

  • Addiction Medicine (Family Medicine) Physician
  • Fort Dodge, IA
National Provider Identifier
1003887431
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
10606 Issued in IA
Practice address
211 Avenue M W
Fort Dodge, IA 50501-5789
Phone
(515) 576-7261
NPI assigned
Feb 1, 2006
Last updated
Jun 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 33067 IA
Addiction Medicine (Family Medicine) Physician 207QA0401X 10606 IA Primary

Addresses

Primary practice location

211 Avenue M W
Fort Dodge, IA 50501-5789

Mailing address

211 Avenue M W Ste a
Fort Dodge, IA 50501-5789
Phone (515) 576-7261

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040604000926 IA Practitioner - Family PracticePractitioner - Emergency Medicine 3678555315 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33067IAMDFamily Medicine Physician
10606IAMDAddiction Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community and Family Resources CurrentSince Sep 17, 2024 Accepting new patients

Locations

1619 S High Ave
Ames, IA 50010
Phone (515) 232-3206

3451 Easton Blvd
Des Moines, IA 50317
Phone (515) 255-3373

4014 Kingman Blvd
Des Moines, IA 50311
Phone (515) 255-3373

211 Avenue M W
Fort Dodge, IA 50501
Phone (515) 576-7261

211 Avenue M W
Ste A
Fort Dodge, IA 50501

430 Southgate Ave
Iowa City, IA 52240
Phone (319) 351-4357

1201 Industrial Park Rd
Washington, IA 52353
Phone (319) 325-9929

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1003887431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 AVENUE M W STE A",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015789",
            "telephone_number": "515-576-7261",
            "fax_number": "515-955-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 AVENUE M W",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015789",
            "telephone_number": "515-576-7261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINION",
        "first_name": "RANDALL",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "33067",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "IA",
            "license": "10606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Dodge, IA

Sources for this page

Verify at the official NPI Registry.