Active NPI
Judith Lynne Nayeri, DO
- Family Medicine Physician
- West Des Moines, IA
National Provider Identifier
1275502007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 02946
- Practice address
- 1701 22ND St
Suite 201
West Des Moines, IA 50266-1443 - Phone
- (515) 440-6622
- Fax
- (515) 440-6698
- NPI assigned
- Mar 15, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 02946 | IA | Primary |
Addresses
Primary practice location
1701 22ND St
Suite 201
West Des Moines, IA 50266-1443
Mailing address
2213 Grand Ave
Des Moines, IA 50312-5305
Phone (515) 237-2974
Other names 1
- Judith Lynne McIvor
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
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02946 | IA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinics, Inc. | Past | Accepting new patients | |
| Craig S Gerhart MD PC | Family Medicine | Past | Accepting new patients |
Organizations & group practices 2
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.
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- NPI 1548452287
-
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- Des Moines, IA
- NPI 1508741505
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246320000000",
"number": "1275502007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2213 GRAND AVE",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503125305",
"telephone_number": "515-237-2974",
"fax_number": "515-883-2692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 22ND ST",
"address_2": "SUITE 201",
"city": "WEST DES MOINES",
"state": "IA",
"postal_code": "502661443",
"telephone_number": "515-440-6622",
"fax_number": "515-440-6698"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAYERI",
"first_name": "JUDITH",
"middle_name": "LYNNE",
"name_prefix": "Mrs.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-03-15",
"last_updated": "2009-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "02946",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JUDITH",
"last_name": "MCIVOR",
"middle_name": "LYNNE",
"credential": "DO",
"code": "5",
"type": "Other Name"
}
]
}Other providers in West 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 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.