NPIMap

Individual provider Active NPI

Mark Thomas Hepworth

  • Psychiatric/Mental Health Nurse Practitioner
  • Spencer, IA
National Provider Identifier
1487232302
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
G162956 Issued in IA
Practice address
1200 1St Ave E Ste 1
Spencer, IA 51301-4330
Phone
(712) 264-6228
NPI assigned
Mar 31, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X G162956 IA Primary

Addresses

Primary practice location

1200 1St Ave E Ste 1
Spencer, IA 51301-4330

Mailing address

1200 1St Ave E Ste 1
Spencer, IA 51301-4330
Phone (712) 264-6228

Other identifiers 1

IdentifierTypeStateIssuer
G162956OtherIAARNP LICENSE NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mark.hepworth@spencerhospital.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
I20210428000627 IA Practitioner - Nurse Practitioner 2567870710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spencer Municipal HospitalGroup PAC ID 4183533060, 95 clinicians

Practice addresses (Care Compare)

1200 1St Ave E
Spencer, IA 51301-4342
Phone (712) 264-6198

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spencer Municipal Hospital CurrentSince Apr 23, 2021 Accepting new patients
Spencer Municipal Hospital Current Accepting new patients
Spencer Municipal Hospital Current Accepting new patients
Spencer Municipal Hospital CurrentSince Apr 23, 2021 Accepting new patients
Northwest Iowa Dermatology LLC PastSince Apr 6, 2021 Accepting new patients

Locations

1200 1st Ave E
Spencer, IA 51301
Phone (712) 264-6164

1200 1st Ave E
Ste 1
Spencer, IA 51301
Phone (712) 264-6160

101 E 10th St
Ste 101
Spencer, IA 51301
Phone (712) 264-3500

Interoperability endpoints

  • Direct secure messaging: mark.hepworth@avera.sdhealthlink.net

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1487232302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 1ST AVE E STE 1",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513014330",
            "telephone_number": "712-264-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 1ST AVE E STE 1",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513014330",
            "telephone_number": "712-264-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEPWORTH",
        "first_name": "MARK",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-31",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G162956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP LICENSE NUMBER",
            "identifier": "G162956",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mark.hepworth@spencerhospital.org",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1200 1st Ave E Ste 1",
            "city": "Spencer",
            "state": "IA",
            "country_code": "US",
            "postal_code": "513014330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spencer, IA

Sources for this page

Verify at the official NPI Registry.