Individual provider Active NPI

Mary Christine Segreto, D.O.

  • Psychiatry Physician
  • Fort Dodge, IA
National Provider Identifier
1083681944
Registry record updated Dec 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
02806 Issued in IA
Practice address
720 Kenyon Rd
North Central Iowa Mental Health Center Inc Dba Unitypo
Fort Dodge, IA 50501-5759
Phone
(515) 955-7171
Fax
(515) 573-7898
NPI assigned
Mar 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 02806 IA Primary

Addresses

Primary practice location

720 Kenyon Rd
North Central Iowa Mental Health Center Inc Dba Unitypo
Fort Dodge, IA 50501-5759

Mailing address

720 Kenyon Rd
North Central Iowa Mental Health Center Inc Dba Unitypo
Fort Dodge, IA 50501-5759
Phone (515) 955-7171

Other identifiers 2

IdentifierTypeStateIssuer
0159608MedicaidIA
07466OtherIAWELLMARK BCBS

Medicare participation

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02806IAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
North Central Iowa Mental Health Center, Inc Past Accepting new patients
Northwest Iowa Mental Health Center Past Accepting new patients
North Central Iowa Mental Health Center Inc Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449014400000",
    "number": "1083681944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 KENYON RD",
            "address_2": "NORTH CENTRAL IOWA MENTAL HEALTH CENTER INC DBA UNITYPO",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015759",
            "telephone_number": "515-955-7171",
            "fax_number": "515-573-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 KENYON RD",
            "address_2": "NORTH CENTRAL IOWA MENTAL HEALTH CENTER INC DBA UNITYPO",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015759",
            "telephone_number": "515-955-7171",
            "fax_number": "515-573-7898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGRETO",
        "first_name": "MARY",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-01",
        "last_updated": "2015-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "02806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0159608",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "07466",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Dodge, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; 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.