Michael David Vannatta, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02160 Issued in IA

Practice address

1202 W Howard St
Knoxville, IA 50138-3103

Phone

(641) 828-7211

Fax

(641) 842-7030

NPI assigned

Aug 1, 2006

Last updated

Jan 7, 2014By 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 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389052800000",
    "number": "1124035357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 W HOWARD ST",
            "city": "KNOXVILLE",
            "state": "IA",
            "postal_code": "501383103",
            "telephone_number": "641-828-7211",
            "fax_number": "641-842-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 W HOWARD ST",
            "city": "KNOXVILLE",
            "state": "IA",
            "postal_code": "501383103",
            "telephone_number": "641-828-7211",
            "fax_number": "641-842-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANNATTA",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2014-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "02160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BC&BS IA",
            "identifier": "45044",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BC&BS IA",
            "identifier": "36316",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2039552",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3039552",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Thompson
• Gretchen Thorson, RD,LD,CDE
• Katheryne Jean Todd, ARNP
• Todd A Treimer, DO
• Jessica Lynn Van Vark, LMSW
• Veterans Health Administration
• Wal-Mart Stores, Inc. (Vision Center 30-2935)
• Mary Walker, NP-C (ARNP)
• Regina Joyce Walker, ARNP
• Walmart Inc. (Walmart Pharmacy 10-2935)

• Family Medicine Physician in Knoxville, IA
• Providers in Knoxville, 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 Jan 7, 2014; 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.