Active NPI
Mark J Dearden, D.O.
- Family Medicine Physician
- Des Moines, IA
National Provider Identifier
1730143397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- DO-03457
- Practice address
- 1540 High St
Suite 101
Des Moines, IA 50309-3106 - Phone
- (515) 237-3985
- Fax
- (515) 237-3994
- NPI assigned
- Apr 12, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 3457 | IA | |
| Family Medicine Physician | 207Q00000X | DO-03457 | IA | Primary |
Addresses
Primary practice location
1540 High St
Suite 101
Des Moines, IA 50309-3106
Mailing address
PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 237-3985
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 Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3457 | IA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401667200000",
"number": "1730143397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1475",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503051475",
"telephone_number": "515-237-3985",
"fax_number": "515-237-3994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1540 HIGH ST",
"address_2": "SUITE 101",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503093106",
"telephone_number": "515-237-3985",
"fax_number": "515-237-3994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEARDEN",
"first_name": "MARK",
"middle_name": "J",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-12",
"last_updated": "2014-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "3457",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "DO-03457",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.