Active NPI
Teresa A Mock, MD
- Family Medicine Physician
- Mason City, IA
National Provider Identifier
1871604835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 26090
- Practice address
- 621 S Illinois Ave
Suite 100
Mason City, IA 50401-5489 - Phone
- (641) 422-6900
- Fax
- (641) 422-6909
- NPI assigned
- Aug 31, 2006
- Last updated
- Aug 22, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 26090 | IA | Primary |
Addresses
Primary practice location
621 S Illinois Ave
Suite 100
Mason City, IA 50401-5489
Mailing address
621 S Illinois Ave
Suite 103
Mason City, IA 50401-5489
Phone (641) 494-3041
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2249078 | Medicaid | IA | |
| 04836 | Other | IA | WELLMARK |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26090 | IA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health Services-Iowa Corp | Past | Accepting new patients | |
| Mercy Medical Center North Iowa | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba MercyOne Northwood Pharmacy
- Community/Retail Pharmacy
- Northwood, IA
- NPI 1316909484
-
dba Mercy Emergency ARNPs
- Nurse Practitioner
- Mason City, IA
- NPI 1548438526
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661126400000",
"number": "1871604835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "621 S ILLINOIS AVE",
"address_2": "SUITE 103",
"city": "MASON CITY",
"state": "IA",
"postal_code": "504015489",
"telephone_number": "641-494-3041",
"fax_number": "641-494-3059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "621 S ILLINOIS AVE",
"address_2": "SUITE 100",
"city": "MASON CITY",
"state": "IA",
"postal_code": "504015489",
"telephone_number": "641-422-6900",
"fax_number": "641-422-6909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOCK",
"first_name": "TERESA",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2022-08-22",
"certification_date": "2022-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "26090",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2249078",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK",
"identifier": "04836",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mason City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.