Active NPI
Trimark Physicians Group
- Family Medicine Physician
- Fort Dodge, IA
National Provider Identifier
1124396387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- TRIMARK PHYSICIANS GROUP
- Practice address
- 800 Kenyon Rd
Suite S
Fort Dodge, IA 50501-5776 - Phone
- (515) 573-4141
- NPI assigned
- Dec 2, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael J. Dewerff
- Title
- Cfo
- Phone
- (515) 574-6603
Specialties & licenses 13
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | |||
| Dermatology Physician | 207N00000X | |||
| Family Medicine Physician | 207Q00000X | Primary | ||
| Gastroenterology Physician | 207RG0100X | |||
| Nephrology Physician | 207RN0300X | |||
| Pulmonary Disease Physician | 207RP1001X | |||
| Obstetrics & Gynecology Physician | 207V00000X | |||
| Pediatrics Physician | 208000000X | |||
| Diagnostic Radiology Physician | 2085R0202X | |||
| Surgery Physician | 208600000X | |||
| Podiatrist | 213E00000X | |||
| Physician Assistant | 363A00000X | |||
| Nurse Practitioner | 363L00000X |
Addresses
Primary practice location
800 Kenyon Rd
Suite S
Fort Dodge, IA 50501-5776
Mailing address
802 Kenyon Rd
Fort Dodge, IA 50501-5740
Phone (515) 574-6890
Other names 1
- UnityPoint Clinic
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322784000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1368403200000",
"number": "1124396387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "802 KENYON RD",
"city": "FORT DODGE",
"state": "IA",
"postal_code": "505015740",
"telephone_number": "515-574-6890",
"fax_number": "515-574-6458"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 KENYON RD",
"address_2": "SUITE S",
"city": "FORT DODGE",
"state": "IA",
"postal_code": "505015776",
"telephone_number": "515-573-4141"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRIMARK PHYSICIANS GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2011-12-02",
"last_updated": "2013-05-13",
"status": "A",
"authorized_official_last_name": "DEWERFF",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "J.",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "515-574-6603"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Allergy & Immunology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dermatology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207RG0100X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Nephrology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Pulmonary Disease",
"state": null,
"license": null,
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Podiatrist",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "UnityPoint Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}
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 May 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.