Gary Janssen, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01785 Issued in IA

Practice address

112 E Detroit Ave
Indianola, IA 50125-1860

Phone

(515) 961-5324

Fax

(515) 961-0116

NPI assigned

Aug 3, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023026689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 6TH AVE",
            "address_2": "SUITE 200",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503142607",
            "telephone_number": "515-643-8672",
            "fax_number": "515-643-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E DETROIT AVE",
            "city": "INDIANOLA",
            "state": "IA",
            "postal_code": "501251860",
            "telephone_number": "515-961-5324",
            "fax_number": "515-961-0116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANSSEN",
        "first_name": "GARY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "01785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3220822",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Iowa Speech Therapy
• Gary Lee Jacobsen, DDS
• Alfreda Jarue
• Jaybird ABA LLC (Jaybird ABA)
• Jaybird Holdings Indianola LLC
• Chris Robert Jensen, M.D.
• Marisa Jensen, PT

• Family Medicine Physician in Indianola, IA
• Providers in Indianola, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.