NPIMap

Organization Active NPI

Trimark Physicians Group Inc

  • Nurse Practitioner
  • Fort Dodge, IA
National Provider Identifier
1467528018
Registry record updated Dec 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
TRIMARK PHYSICIANS GROUP INC
Practice address
800 Kenyon Rd
Fort Dodge, IA 50501-5776
Phone
(515) 573-4141
NPI assigned
Nov 27, 2006
Organization subpart
Yes
Parent organization
TRINITY HEALTH SYSTEMS INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 22, 2010

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

Authorized official

Name
Michael J Dewerff
Title
Cfo
Phone
(515) 574-6603

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

800 Kenyon Rd
Fort Dodge, IA 50501-5776

Mailing address

800 Kenyon Rd
Fort Dodge, IA 50501-5776
Phone (515) 573-4141

Other identifiers 1

IdentifierTypeStateIssuer
0424929MedicaidIA

Other names 1

  • Trimark Physicians Group Inc - ARNP Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Park Physicians PPMC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292976000000",
    "number": "1467528018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 KENYON RD",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015776",
            "telephone_number": "515-573-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 KENYON RD",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015776",
            "telephone_number": "515-573-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIMARK PHYSICIANS GROUP INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRINITY HEALTH SYSTEMS INC.",
        "enumeration_date": "2006-11-27",
        "last_updated": "2010-12-22",
        "status": "A",
        "authorized_official_last_name": "DEWERFF",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "515-574-6603"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0424929",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trimark Physicians Group Inc - ARNP",
            "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 22, 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.

Verify at the official NPI Registry.