Individual provider Active NPI

Erin Jeanette Fish, DO

  • Internal Medicine Physician
  • Urbandale, IA
National Provider Identifier
1073554069
Registry record updated Nov 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO-03805 Issued in IA
Practice address
4005 NW Urbandale Dr
Urbandale, IA 50322-7914
Phone
(515) 643-9500
Fax
(515) 643-9525
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101014736 MI
Internal Medicine Physician 207R00000X DO-03805 IA Primary

Addresses

Primary practice location

4005 NW Urbandale Dr
Urbandale, IA 50322-7914

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 643-9500

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
I20070726000151 IA Practitioner - Internal Medicine 6608853098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinics IncGroup PAC ID 7911810882, 441 clinicians

Practice addresses (Care Compare)

411 Laurel St
Suite 3262
Des Moines, IA 50314-3027
Phone (515) 643-5203

Hospital & facility affiliations

  • Mercyone Des Moines Home Care Home health agency, Des Moines, IA, CCN 167133
  • Mercyone Des Moines Medical Center Hospital, Des Moines, IA, CCN 160083

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinics, Inc. CurrentSince Oct 5, 2015 Accepting new patients
Mercy Clinics, Inc. Current Accepting new patients
Mercy Clinics, Inc CurrentSince Oct 5, 2015 Accepting new patients
Hospital Health Care Inc. Internal Medicine Past Accepting new patients

Locations

1601 NW 114th St
Ste 342
Clive, IA 50325
Phone (515) 222-7600

1601 NW 114th St
Ste 247
Des Moines, IA 50325
Phone (515) 222-7000

330 Laurel St
Ste 1200
Des Moines, IA 50314
Phone (515) 643-5454

1111 6th Ave
Des Moines, IA 50314
Phone (515) 247-3121

405 SW 5th St
Ste E
Des Moines, IA 50309
Phone (515) 358-7259

411 Laurel St
Ste 3262
Des Moines, IA 50314
Phone (515) 643-5100

1111 6th Ave
#4S
Des Moines, IA 50314
Phone (515) 247-4240

5900 E University Ave
Ste 100
Pleasant Hill, IA 50327
Phone (515) 643-2400

4005 NW Urbandale Dr
Urbandale, IA 50322
Phone (515) 643-9200

25 W Hickman Rd
Waukee, IA 50263
Phone (515) 358-0150

Interoperability endpoints

  • Direct secure messaging: efish3944312@direct.trinity-health.org

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1073554069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-643-9500",
            "fax_number": "515-643-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 NW URBANDALE DR",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503227914",
            "telephone_number": "515-643-9500",
            "fax_number": "515-643-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISH",
        "first_name": "ERIN",
        "middle_name": "JEANETTE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101014736",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "DO-03805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbandale, IA

Sources for this page

Verify at the official NPI Registry.