Suzanne N Kersbergen, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

04277 Issued in IA

Practice address

1410 6TH Ave So
Clear Lake, IA 50428-2606

Phone

(641) 357-2191

Fax

(641) 357-6020

NPI assigned

Jun 15, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Suzanne N Friedel Former name

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• North Iowa Mercy Clinics

  • Anesthesiology Physician
  • Mason City, IA
  • NPI 1780278242
  Medicare reassignment NPD
• North Iowa Mercy Clinics

  • Family Medicine Physician
  • Clear Lake, IA
  • NPI 1790895654
  NPD
• North Iowa Mercy Clinics

  • Family Medicine Physician
  • Mason City, IA
  • NPI 1922118918
  NPD (past)

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

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1770710980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S ILLINOIS AVE STE 103",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504015489",
            "telephone_number": "641-428-3041",
            "fax_number": "641-428-3059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 6TH AVE SO",
            "city": "CLEAR LAKE",
            "state": "IA",
            "postal_code": "504282606",
            "telephone_number": "641-357-2191",
            "fax_number": "641-357-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSBERGEN",
        "first_name": "SUZANNE",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-15",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS14053",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "4277",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "04277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZANNE",
            "last_name": "FRIEDEL",
            "middle_name": "N",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Integrative Medicine Consultants, Inc.
• Brittney Jacobson, SLP
• Kaylee Jeffrey
• Anne Jones, ARNP
• Carson James Kern
• Rick Knudson, PHARM.D., BCPS
• Tate Allen Lage, D.O.
• Lake Dental Associates PC
• Petra Lamfers, ARNP
• Britta Ann Lee, PHARMD

• Family Medicine Physician in Clear Lake, IA
• Providers in Clear Lake, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.