Individual provider Active NPI

Larae Gail Stemmerman, D.O.

  • Family Medicine Physician
  • Marion, IA
National Provider Identifier
1427040930
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3297 Issued in IA
Practice address
905 29TH Ave Ste 120
Marion, IA 52302-1138
Phone
(319) 826-6374
Fax
(319) 826-6377
NPI assigned
Aug 19, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3297 IA Primary

Addresses

Primary practice location

905 29TH Ave Ste 120
Marion, IA 52302-1138

Mailing address

905 29TH Ave
Marion, IA 52302-1108
Phone (319) 470-1536

Other identifiers 1

IdentifierTypeStateIssuer
2207654MedicaidIA

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
3603OKMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Infinity Medical Clinic PC Family Medicine CurrentSince Aug 1, 2019 Accepting new patients
Planned Parenthood of the Heartland Past Accepting new patients
Southeast Iowa Regional Medical Center, Inc. Past Accepting new patients

Locations

5409 Avenue O
Ste 115
Fort Madison, IA 52627
Phone (319) 372-5465

5409 Avenue O
Ste 126
Fort Madison, IA 52627
Phone (319) 372-5925

905 29th Ave
Ste 120
Marion, IA 52302
Phone (319) 826-6374

905 29th Ave
Marion, IA 52302
Phone (319) 200-2066

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FAJHBD/Endpoint/FAJHBD

Organizations & group practices 3

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": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1427040930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 29TH AVE",
            "city": "MARION",
            "state": "IA",
            "postal_code": "523021108",
            "telephone_number": "319-470-1536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 29TH AVE STE 120",
            "city": "MARION",
            "state": "IA",
            "postal_code": "523021138",
            "telephone_number": "319-826-6374",
            "fax_number": "319-826-6377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEMMERMAN",
        "first_name": "LARAE",
        "middle_name": "GAIL",
        "name_prefix": "Ms.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-19",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "3297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2207654",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.