Active NPI
Brandon Petree, DO
- Surgery Physician
- Des Moines, IA
National Provider Identifier
1205402286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- R-12072
- Practice address
- 1111 6TH Ave
Des Moines, IA 50314-2613 - Phone
- (515) 643-2261
- Fax
- (515) 643-5802
- NPI assigned
- Jun 1, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | R-12072 | IA | Primary |
Addresses
Primary practice location
1111 6TH Ave
Des Moines, IA 50314-2613
Mailing address
PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 643-2261
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622505600000",
"number": "1205402286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1475",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503051475",
"telephone_number": "515-643-2261",
"fax_number": "515-643-5802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 6TH AVE",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503142613",
"telephone_number": "515-643-2261",
"fax_number": "515-643-5802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETREE",
"first_name": "BRANDON",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-01",
"last_updated": "2021-06-01",
"certification_date": "2021-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IA",
"license": "R-12072",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.