Individual provider Active NPI

C. Dan Meyer, PA-C

  • Physician Assistant
  • Manchester, IA
National Provider Identifier
1255339800
Registry record updated May 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
000952 Issued in IA
Practice address
709 W Main St
Manchester, IA 52057-1526
Phone
(563) 927-7985
Fax
(563) 927-7934
NPI assigned
Jul 8, 2005
Last updated
May 17, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 000952 IA Primary

Addresses

Primary practice location

709 W Main St
Manchester, IA 52057-1526

Mailing address

709 W Main St
P.O. Box 359
Manchester, IA 52057-1526
Phone (563) 927-7985

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
00952IAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368748800000",
    "number": "1255339800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 W MAIN ST",
            "address_2": "P.O. BOX 359",
            "city": "MANCHESTER",
            "state": "IA",
            "postal_code": "520571526",
            "telephone_number": "563-927-7985",
            "fax_number": "563-927-7934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 W MAIN ST",
            "city": "MANCHESTER",
            "state": "IA",
            "postal_code": "520571526",
            "telephone_number": "563-927-7985",
            "fax_number": "563-927-7934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "C.",
        "middle_name": "DAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2013-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "000952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.

Verify at the official NPI Registry.