Timothy L Evert, DO
Individual provider Active NPI Family Medicine Physician · Des Moines, IA
NPI 1699785477 · NPPES record last updated Jan 29, 2010
Key facts
- NPI
- 1699785477
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 03025 (IA)
- Practice address
- 6601 SW 9TH St
Des Moines, IA 50315-6138 - Phone
- (515) 643-9400
- Fax
- (515) 643-9405
- NPI assigned
- Aug 8, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100122000773 | IA | Practitioner - Emergency Medicine |
4385786789 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boone County Hospital | Current |
Accepting new patients | |
| Boone County Hospital | Current | Accepting new patients | |
| Boone County Hospital | Current | Accepting new patients | |
| Boone County Hospital | Current |
Accepting new patients |
Locations
2605 SW White Birch Dr
Ankeny, IA 50023
Phone (515) 643-7100
1015 Union St
Boone, IA 50036
Phone (515) 432-3140
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 03025 | IA | Yes |
Addresses
Primary practice location
6601 SW 9TH St
Des Moines, IA 50315-6138
Mailing address
PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 643-9400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3151621 | Medicaid | IA |
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All providers in Des Moines, IA · Family Medicine Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.