Siouxland Adult Medicine, PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

127854 Issued in IA

Legal business name

SIOUXLAND ADULT MEDICINE, PLLC

Practice address

2800 Pierce St
Suite 410
Sioux City, IA 51104-3755

Phone

(712) 234-1005

NPI assigned

Aug 5, 2008

Last updated

Aug 5, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark O Carlson, M.D.NPI 1609837368

Title

Internal Medicine

Phone

(712) 234-1005

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23894/brand/1/csg/1/fhir/r4

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark O. Carlson, M.D.

  • Internal Medicine Physician
  • Sioux City, IA
  • NPI 1609837368
  Medicare reassignment Care Compare group Authorized official
• Roha Abera

  • Primary Care Nurse Practitioner
  • Sioux City, IA
  • NPI 1841928991
  Medicare reassignment Care Compare group NPD
• Garry Andrew Clark, D.O.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Sioux City, IA
  • NPI 1952380750
  Medicare reassignment
• David H. Daniels, M.D.

  • Internal Medicine Physician
  • Sioux City, IA
  • NPI 1972558229
  Medicare reassignment
• Tyler Nielsen

  • Family Nurse Practitioner
  • Lone Tree, CO
  • NPI 1154056000

  IA

  Medicare reassignment
• Ann Wendel, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Bethel, AK
  • NPI 1225714231

  IA

  Medicare reassignment
• Dawn M Bricker, FNP

  • Family Nurse Practitioner
  • Sioux City, IA
  • NPI 1790061612
  NPD (past)
• Christopher Vincent Laures, D.C.

  • Chiropractor
  • Sioux City, IA
  • NPI 1629250972
  NPD (past)

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

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217894400000",
    "number": "1295991677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 PIERCE ST",
            "address_2": "SUITE 410",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511043755",
            "telephone_number": "712-234-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 PIERCE ST",
            "address_2": "SUITE 410",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511043755",
            "telephone_number": "712-234-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIOUXLAND ADULT MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-05",
        "last_updated": "2008-08-05",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "INTERNAL MEDICINE",
        "authorized_official_telephone_number": "712-234-1005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IA",
            "license": "127854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sioux City Family Dentistry
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• Sioux City Hospitalist Group, LLC
• Sioux City Optometric Center, P C
• Sioux City Physical Therapy PC (Sioux City Physical Therapy)
• Siouxland Aging Services Inc.
• Siouxland Community Health Center (Siouxland Community Health Riverside)
• Siouxland Community Health Center
• Siouxland Community Health Center (Siouxland Community Health Center Pharmacy)
• Siouxland Community Health Center (Siouxland Community Health Riverside Pharmacy)

• Specialist in Sioux City, IA
• Providers in Sioux City, IA by specialty
• Specialist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.