NPIMap

Individual provider Active NPI

David Lawrence Fahey, D.O..

  • Family Medicine Physician
  • Independence, IA
National Provider Identifier
1467833632
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R-10379 Issued in IA
Practice address
1600 1St St E
Independence, IA 50644-3155
Phone
(319) 332-0999
NPI assigned
Jun 14, 2015
Last updated
Jan 7, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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 R-10379 IA Primary

Addresses

Primary practice location

1600 1St St E
Independence, IA 50644-3155

Mailing address

1600 1St St E
Independence, IA 50644-3155
Phone (319) 332-0999

Other practice location 1

1801 Hickman Rd
Des Moines, IA 50314-1505
Phone (515) 282-5640

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dfahey@bchealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170918000232 IA Practitioner - Family PracticePractitioner - Emergency Medicine 6406168954 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peoples Memorial HospitalGroup PAC ID 9931010790, shared by 7 NPIs, 47 clinicians

Practice addresses (Care Compare)

1600 1St St E
Independence, IA 50644-3155
Phone (319) 332-0999

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
50.17 of 100Reported as apm
Quality
55.61
Promoting interoperability
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
R-10379IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Broadlawns Medical Center CurrentSince Sep 1, 2017 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
People's Memorial Hospital Current Accepting new patients
People's Memorial Hospital Family Medicine CurrentSince Aug 1, 2018 Accepting new patients
Broadlawns Medical Center CurrentSince Sep 1, 2017 Accepting new patients
People's Memorial Hospital Family Medicine CurrentSince Aug 1, 2018 Accepting new patients
People's Memorial Hospital CurrentSince Aug 1, 2018 Accepting new patients

Locations

1801 Hickman Rd
Des Moines, IA 50314
Phone (515) 282-2200

1801 Hickman Rd
Apt 6
Des Moines, IA 50314

1100 1st St E
Independence, IA 50644
Phone (319) 334-2541

1600 1st St E
Independence, IA 50644
Phone (319) 332-0999

211 South St W
Jesup, IA 50648
Phone (319) 332-0999

2405 Rock Island Rd
Oelwein, IA 50662
Phone (319) 283-2651

Interoperability endpoints

  • Direct secure messaging: dfahey@bchealth.org
  • Direct secure messaging: dfahey207627@direct.unitypoint.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
BCHC Family Medicine - JesupJesup, IA, CCN 168640 Rural health clinic W-2 Managing Employee
Operational/Managerial Control		 Jan 13, 2020
Jan 13, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1434240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1467833632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 1ST ST E",
            "city": "INDEPENDENCE",
            "state": "IA",
            "postal_code": "506443155",
            "telephone_number": "319-332-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 1ST ST E",
            "city": "INDEPENDENCE",
            "state": "IA",
            "postal_code": "506443155",
            "telephone_number": "319-332-0999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 Hickman Rd",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503141505",
            "country_code": "US",
            "telephone_number": "515-282-5640",
            "fax_number": "515-282-2332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAHEY",
        "first_name": "DAVID",
        "middle_name": "LAWRENCE",
        "credential": "D.O..",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-14",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "R-10379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dfahey@bchealth.org",
            "affiliation": "N",
            "endpointDescription": "Buchanan County Health Center Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1600 1st St E",
            "city": "Independence",
            "state": "IA",
            "country_code": "US",
            "postal_code": "506443155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Independence, IA

Sources for this page

Verify at the official NPI Registry.