Douglas Raymond Pick, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

06598 Issued in IA

Practice address

1250 NW 142ND St
Ste 201
Clive, IA 50325-8346

Phone

(515) 222-0505

Fax

(515) 222-9942

NPI assigned

Mar 2, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Broadlawns Medical Center

  • General Acute Care Hospital
  • Des Moines, IA
  • NPI 1467447508

  IA

  Medicare reassignment NPD
• Broadlawns Medical Center

  • Pharmacy
  • Des Moines, IA
  • NPI 1013197060
  NPD
• Broadlawns Medical Center

  • Psychiatric Hospital Unit
  • Des Moines, IA
  • NPI 1962662379
  NPD

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1215066741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 NW 142ND ST",
            "address_2": "STE 201",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258346",
            "telephone_number": "515-222-0505",
            "fax_number": "515-222-9942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 NW 142ND ST",
            "address_2": "STE 201",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258346",
            "telephone_number": "515-222-0505",
            "fax_number": "515-222-9942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICK",
        "first_name": "DOUGLAS",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "06598",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Jo Pfundheller, ARNP
• Janalyn Phillips
• Phippsburger Inc
• PHS Walnut Ridge LLC
• Ai Huong Phu, D.O.
• Molly Anne Pieper
• Todd Randall Pietig, O.D.
• Kate Pithan, PA-C
• Shana Plambeck
• Poeppe Expert Psychological Services PLLC

• All providers in Clive, IA
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; 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.

Verify at the official NPI Registry.