Active NPI
John Dennis O Brien, MD
- Pediatrics Physician
- Oskaloosa, IA
National Provider Identifier
1497740203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 29352
- Practice address
- 410 N 12TH St
Suite 100
Oskaloosa, IA 52577-2495 - Phone
- (641) 672-3360
- Fax
- (641) 672-3366
- NPI assigned
- Sep 19, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 29352 | IA | Primary |
Addresses
Primary practice location
410 N 12TH St
Suite 100
Oskaloosa, IA 52577-2495
Mailing address
410 N 12TH St
Suite 100
Oskaloosa, IA 52577-2495
Phone (641) 672-3360
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0097964 | Medicaid | IA | |
| 51223 | Other | IA | WELLMARK, INC BCBS OF IOW |
| 62769 | Other | IA | IOWA HEALTH SOLUTIONS |
| G005 | Other | IA | TRIWEST |
| 42068106028 | Other | IA | JOHN DEERE HEALTH |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29352 | IA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354665600000",
"number": "1497740203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 N 12TH ST",
"address_2": "SUITE 100",
"city": "OSKALOOSA",
"state": "IA",
"postal_code": "525772495",
"telephone_number": "641-672-3360",
"fax_number": "641-672-3366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 N 12TH ST",
"address_2": "SUITE 100",
"city": "OSKALOOSA",
"state": "IA",
"postal_code": "525772495",
"telephone_number": "641-672-3360",
"fax_number": "641-672-3366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O BRIEN",
"first_name": "JOHN",
"middle_name": "DENNIS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-19",
"last_updated": "2012-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IA",
"license": "29352",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0097964",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK, INC BCBS OF IOW",
"identifier": "51223",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IOWA HEALTH SOLUTIONS",
"identifier": "62769",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIWEST",
"identifier": "G005",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE HEALTH",
"identifier": "42068106028",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oskaloosa, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.