Active NPI
Trimark Physicians Group Inc
- Diagnostic Radiology Physician
- Fort Dodge, IA
National Provider Identifier
1376869826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- TRIMARK PHYSICIANS GROUP INC
- Practice address
- 802 Kenyon Rd
Fort Dodge, IA 50501-5740 - Phone
- (515) 574-6605
- Fax
- (515) 573-8710
- NPI assigned
- Apr 8, 2010
- Organization subpart
- Yes
- Parent organization
- TRIMARK PHYSICIANS GROUP INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael J Dewerff
- Title
- Chief Financial Officer
- Phone
- (515) 574-6603
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | Primary |
Addresses
Primary practice location
802 Kenyon Rd
Fort Dodge, IA 50501-5740
Mailing address
802 Kenyon Rd
Fort Dodge, IA 50501-5740
Phone (515) 574-6605
Other names 1
- Trimark Radiology
National Provider Directory
National Provider Directory- Part of
- Park Physicians PPMC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270684800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1293062400000",
"number": "1376869826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "802 KENYON RD",
"city": "FORT DODGE",
"state": "IA",
"postal_code": "505015740",
"telephone_number": "515-574-6605",
"fax_number": "515-573-8710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "802 KENYON RD",
"city": "FORT DODGE",
"state": "IA",
"postal_code": "505015740",
"telephone_number": "515-574-6605",
"fax_number": "515-573-8710"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRIMARK PHYSICIANS GROUP INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "TRIMARK PHYSICIANS GROUP INC",
"enumeration_date": "2010-04-08",
"last_updated": "2010-12-23",
"status": "A",
"authorized_official_last_name": "DEWERFF",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "515-574-6603"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Trimark Radiology",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Fort Dodge, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.