Individual provider Active NPI

Eric R Recker, D.D.S.

  • Dentist
  • Pella, IA
National Provider Identifier
1750527503
Registry record updated Dec 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
08148 Issued in IA
Practice address
935 Main St
Pella, IA 50219-1434
Phone
(641) 628-1604
Fax
(641) 628-2075
NPI assigned
Dec 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 08148 IA Primary

Addresses

Primary practice location

935 Main St
Pella, IA 50219-1434

Mailing address

935 Main St
Pella, IA 50219-1434
Phone (641) 628-1604

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151008001562 IA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9739497934

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08148IAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark W Recker DDS Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1230508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230508800000",
    "number": "1750527503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 MAIN ST",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502191434",
            "telephone_number": "641-628-1604",
            "fax_number": "641-628-2075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 MAIN ST",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502191434",
            "telephone_number": "641-628-1604",
            "fax_number": "641-628-2075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RECKER",
        "first_name": "ERIC",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-29",
        "last_updated": "2008-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "08148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pella, IA

Sources for this page

Verify at the official NPI Registry.