Jerald Joe Phipps, DO – Family Medicine Physician

Key facts

NPI: 1043288756
Entity type: Individual (NPI type 1)
Primary specialty: Family Medicine Physician 207Q00000X
License: 02765 (IA)
Practice address: 504 N Cleveland St
Mount Ayr, IA 50854-2201
Phone: (641) 464-3226
Fax: (614) 464-4476
NPI assigned: Mar 9, 2006
Sex: Male
Sole proprietor: No

Organizations & group practices 1

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

Mercy Clinics, Inc. Obstetrics & Gynecology Physician · Des Moines, IA · NPI 1508741505

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Osteopathy, Doctor of Medicine

State licenses

License	State	Type	Specialty
02765	IA	MD	Family Medicine Physician

Practice roles

Organization	Specialty	Status	New patients
Mercy Clinics, Inc.		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Medicine Physician	207Q00000X	02765	IA	Yes

Addresses

Primary practice location

504 N Cleveland St
Mount Ayr, IA 50854-2201

Mailing address

804 E Adams St
Mount Ayr, IA 50854-1509
Phone (515) 230-1630

Other identifiers

Identifier	Type	State	Issuer
2091249	Medicaid	IA

Other providers in Mount Ayr, IA

All providers in Mount Ayr, IA · Family Medicine Physician in Iowa

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2013. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.