David G Detert, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

23504 Issued in MN

Practice address

1705 N Highway 20
Cannon Falls, MN 55009-1187

Phone

(507) 288-3443

Fax

(507) 529-6622

NPI assigned

Feb 23, 2006

Last updated

Mar 4, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carris Health LLC

  • Multi-Specialty Clinic/Center
  • Willmar, MN
  • NPI 1598236408
  NPD

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393891200000",
    "number": "1902872641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 441",
            "address_2": "520 SOUTH SIBLEY AVE",
            "city": "LITCHFIELD",
            "state": "MN",
            "postal_code": "55355",
            "telephone_number": "320-693-3233",
            "fax_number": "320-693-3290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 N HIGHWAY 20",
            "city": "CANNON FALLS",
            "state": "MN",
            "postal_code": "550091187",
            "telephone_number": "507-288-3443",
            "fax_number": "507-529-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETERT",
        "first_name": "DAVID",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2014-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "23504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "467805200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chasing Life-With Kala Marie
• Evie Christensen
• City of Cannon Falls (Cannon Falls Ambulance)
• Compass Dental PA
• Fiona Ethel Demel, D.C.
• Fiona E. Fletcher D.C. LTD. (Body Works Clinic)
• Jennifer Lynn Fogarty, DPT
• Daniel Scott Freeman
• Erin Marie Friesenborg, CCP
• Glazon Group, Inc. (Cannon Country)

• Family Medicine Physician in Cannon Falls, MN
• Providers in Cannon Falls, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.