NPIMap

Organization Active NPI

Decatur Medical Services, PC

  • Family Medicine Physician
  • Leon, IA
National Provider Identifier
1346219052
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DECATUR MEDICAL SERVICES, PC
Practice address
1404 NW Church St
Leon, IA 50144-1266
Phone
(641) 446-4863
Fax
(641) 446-3576
NPI assigned
Mar 15, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Larry Wayne Richard, M.D.NPI 1134197643
Title
President
Phone
(641) 446-4863

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1404 NW Church St
Leon, IA 50144-1266

Mailing address

1404 NW Church St
Leon, IA 50144-1266
Phone (641) 446-4863

Other identifiers 1

IdentifierTypeStateIssuer
0200295MedicaidIA

National Provider Directory

National Provider Directory
Tax ID family
Decatur Medical Services PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1404 NW Church St
Leon, IA 50144
Phone (641) 446-4863

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346219052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 NW CHURCH ST",
            "city": "LEON",
            "state": "IA",
            "postal_code": "501441266",
            "telephone_number": "641-446-4863",
            "fax_number": "641-446-3576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 NW CHURCH ST",
            "city": "LEON",
            "state": "IA",
            "postal_code": "501441266",
            "telephone_number": "641-446-4863",
            "fax_number": "641-446-3576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR MEDICAL SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RICHARD",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "641-446-4863",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0200295",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leon, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.