NPIMap

Individual provider Active NPI

David S. Demarest, PH.D

  • Clinical Neuropsychologist
  • Ankeny, IA
National Provider Identifier
1336185933
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Practice address
715 SW Ankeny Rd
On With Life
Ankeny, IA 50023-9798
Phone
(515) 965-1339
Fax
(515) 964-0567
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 00971 IA
Clinical Neuropsychologist 103G00000X Primary

Addresses

Primary practice location

715 SW Ankeny Rd
On With Life
Ankeny, IA 50023-9798

Mailing address

715 SW Ankeny Rd
On With Life
Ankeny, IA 50023-9798
Phone (515) 965-1339

Other identifiers 4

IdentifierTypeStateIssuer
38361OtherIAWELLMARK
6552280MedicaidSD
0457184MedicaidIA
100251333-00MedicaidNE

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 Philosophy

State licenses

LicenseStateTypeSpecialty
00971IAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Health Immanuel Medical Center Past Accepting new patients
On With Life, Inc. Clinical Neuropsychologist Past Accepting new patients
Better Living Counseling Services, Inc. Past Accepting new patients
On With Life, Inc Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1336185933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 SW ANKENY RD",
            "address_2": "ON WITH LIFE",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500239798",
            "telephone_number": "515-965-1339",
            "fax_number": "515-964-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 SW ANKENY RD",
            "address_2": "ON WITH LIFE",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500239798",
            "telephone_number": "515-965-1339",
            "fax_number": "515-964-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMAREST",
        "first_name": "DAVID",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IA",
            "license": "00971",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "38361",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6552280",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0457184",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100251333-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ankeny, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; 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.