Trimark Physicians Group

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

TRIMARK PHYSICIANS GROUP

Doing business as

UnityPoint Clinic Laboratory

Practice address

800 Kenyon Rd
Suite P
Fort Dodge, IA 50501-5776

Phone

(515) 574-6079

Fax

(515) 573-4855

NPI assigned

Dec 27, 2011

Last updated

May 13, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

TRIMARK PHYSICIANS GROUPAs reported in NPPES

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

Authorized official

Name

Michael J. Dewerff

Title

Cfo

Phone

(515) 574-6603

Specialties & licenses 1

Addresses

Other names 1

• UnityPoint Clinic Laboratory Doing business as

Part of

Trimark Physicians Group

Locations

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

{
    "created_epoch": "1324944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368403200000",
    "number": "1013286673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 KENYON RD",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015740",
            "telephone_number": "515-574-6890",
            "fax_number": "515-574-6458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 KENYON RD",
            "address_2": "SUITE P",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015776",
            "telephone_number": "515-574-6079",
            "fax_number": "515-573-4855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIMARK PHYSICIANS GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRIMARK PHYSICIANS GROUP",
        "enumeration_date": "2011-12-27",
        "last_updated": "2013-05-13",
        "status": "A",
        "authorized_official_last_name": "DEWERFF",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "515-574-6603"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UnityPoint Clinic Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Medical Laboratory in Fort Dodge, IA
• Providers in Fort Dodge, IA by specialty
• Clinical Medical Laboratory in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2013; 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.