Madison County Medical Assoc, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02175 Issued in IA

Legal business name

MADISON COUNTY MEDICAL ASSOC, PC

Practice address

60 E Court Ave
Winterset, IA 50273-1517

Phone

(515) 462-1162

Fax

(515) 462-2331

NPI assigned

Oct 23, 2006

Last updated

Jan 30, 2009By 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. Kevin Vincent De Regnier, DO

Title

President

Phone

(515) 462-1162

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233273600000",
    "number": "1386727204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 192",
            "city": "WINTERSET",
            "state": "IA",
            "postal_code": "502730192",
            "telephone_number": "515-462-1162",
            "fax_number": "515-462-2331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 E COURT AVE",
            "city": "WINTERSET",
            "state": "IA",
            "postal_code": "502731517",
            "telephone_number": "515-462-1162",
            "fax_number": "515-462-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON COUNTY MEDICAL ASSOC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2009-01-30",
        "status": "A",
        "authorized_official_last_name": "DE REGNIER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "VINCENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-462-1162",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "02175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS GROUP",
            "identifier": "26985",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0269852",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Winterset, IA
• Providers in Winterset, IA by specialty
• Family Medicine Physician in Iowa

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

Verify at the official NPI Registry.