Kristin Avery, DO
Individual provider Active NPI Pediatrics Physician · Clear Lake, IA
NPI 1710415005 · NPPES record last updated Jul 9, 2025
Key facts
- NPI
- 1710415005
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 05513 (IA)
- Practice address
- 401 S 15TH St
Clear Lake, IA 50428-2303 - Phone
- (641) 357-7442
- Fax
- (641) 357-3070
- NPI assigned
- May 31, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| I20200910002662 | IA | Practitioner - Pediatric Medicine | 9931479136 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05513 | IA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Iowa Mercy Clinics | Current |
Accepting new patients | |
| North Iowa Mercy Clinics | Current | Accepting new patients | |
| North Iowa Mercy Clinics | Current |
Accepting new patients | |
| Floyd County Memorial Hospital Commission | Past | Accepting new patients |
Locations
401 S 15th St
Clear Lake, IA 50428
Phone (641) 357-3393
Interoperability endpoints
- kavery3939023@direct.trinity-health.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | R-10935 | IA | |
| Pediatrics Physician | 208000000X | 05513 | IA | Yes |
Addresses
Primary practice location
401 S 15TH St
Clear Lake, IA 50428-2303
Mailing address
401 S 15TH St
Clear Lake, IA 50428-2303
Phone (641) 357-7442
Other names
- Kristin Weigel
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kavery3939023@direct.trinity-health.org | Direct |
Other providers in Clear Lake, IA
- Acupuncture & Chiropractic, P.C.
- Mindy Allenstein
- Jeffery A. Anderson
- Apple Valley Assisted Living LLC.
- Amber Ashland
- Barillas Clinic LLC
- Roger O Barillas
- Josiah Bartlett
- Joseph Bedford
- Beth Angela Benesh
All providers in Clear Lake, IA · Pediatrics 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 Jul 9, 2025. 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.