Individual provider Active NPI

Philip L Myer, D.O.

  • Family Medicine Physician
  • Manning, IA
National Provider Identifier
1710973391
Registry record updated Jun 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
04199 Issued in IA
Practice address
1550 6TH Street
Manning, IA 51455-1004
Phone
(712) 655-2072
Fax
(712) 655-3228
NPI assigned
Sep 20, 2005
Last updated
Jun 13, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2014

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 04199 IA Primary

Addresses

Primary practice location

1550 6TH Street
Manning, IA 51455-1004

Mailing address

1550 6TH St
Manning, IA 51455-1005
Phone (712) 655-2072

Other identifiers 1

IdentifierTypeStateIssuer
0091405MedicaidIA

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)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04199IAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402617600000",
    "number": "1710973391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 6TH ST",
            "city": "MANNING",
            "state": "IA",
            "postal_code": "514551005",
            "telephone_number": "712-655-2072",
            "fax_number": "712-655-3228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 6TH STREET",
            "city": "MANNING",
            "state": "IA",
            "postal_code": "514551004",
            "telephone_number": "712-655-2072",
            "fax_number": "712-655-3228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYER",
        "first_name": "PHILIP",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2014-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "04199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0091405",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manning, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.