NPIMap

Organization Active NPI

Decatur Medical Services, PC

  • Family Medicine Physician
  • Lamoni, IA
National Provider Identifier
1104895044
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02206 Issued in IA
Legal business name
DECATUR MEDICAL SERVICES, PC
Practice address
802 Ackerly St
Lamoni, IA 50140-1544
Phone
(641) 784-3371
Fax
(641) 784-6162
NPI assigned
Mar 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mark E Easter, D.O.
Title
Vice President
Phone
(641) 784-3371

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 02206 IA Primary

Addresses

Primary practice location

802 Ackerly St
Lamoni, IA 50140-1544

Mailing address

802 Ackerly St
Lamoni, IA 50140-1544
Phone (641) 784-3371

Other identifiers 1

IdentifierTypeStateIssuer
0200261MedicaidIA

National Provider Directory

National Provider Directory
Tax ID family
Decatur Medical Services PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104895044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 ACKERLY ST",
            "city": "LAMONI",
            "state": "IA",
            "postal_code": "501401544",
            "telephone_number": "641-784-3371",
            "fax_number": "641-784-6162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 ACKERLY ST",
            "city": "LAMONI",
            "state": "IA",
            "postal_code": "501401544",
            "telephone_number": "641-784-3371",
            "fax_number": "641-784-6162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR MEDICAL SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EASTER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "641-784-3371",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "02206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0200261",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lamoni, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.