Individual provider Active NPI

Troy Donovan Ivey, D.O.

  • Surgery Physician
  • Waverly, IA
National Provider Identifier
1194719088
Registry record updated Oct 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2845 Issued in IA
Practice address
312 9TH St SW
Waverly, IA 50677-2929
Phone
(319) 352-8033
Fax
(319) 352-8034
NPI assigned
Sep 7, 2005
Last updated
Oct 9, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2845 IA Primary

Addresses

Primary practice location

312 9TH St SW
Waverly, IA 50677-2929

Mailing address

312 9TH St SW
Waverly, IA 50677-2929
Phone (319) 352-8033

Other identifiers 2

IdentifierTypeStateIssuer
16446OtherIABLUE CROSS BLUE SHIELD
0112821MedicaidIA

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
I20041130000997 IA Practitioner - General SurgeryPractitioner - General Practice 1951366012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: General Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Waverly Health CenterGroup PAC ID 8820996762, 44 clinicians

Practice addresses (Care Compare)

312 9TH St SW
Waverly, IA 50677-2929
Phone (319) 352-4120

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2845IAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Waverly Health Center CurrentSince Nov 1, 2013 Accepting new patients
Waverly Health Center Surgery CurrentSince Nov 1, 2013 Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients
Jason Dierking, MD PLLC Surgery Past Accepting new patients

Locations

312 9th St SW
Waverly, IA 50677
Phone (319) 352-4120

312 9th St SW
Ste 3000
Waverly, IA 50677
Phone (319) 352-8891

Interoperability endpoints

  • Direct secure messaging: troy.ivey@waverly.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1194719088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 9TH ST SW",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506772929",
            "telephone_number": "319-352-8033",
            "fax_number": "319-352-8034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 9TH ST SW",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506772929",
            "telephone_number": "319-352-8033",
            "fax_number": "319-352-8034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVEY",
        "first_name": "TROY",
        "middle_name": "DONOVAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "2845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "16446",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0112821",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waverly, IA

Sources for this page

Verify at the official NPI Registry.