Individual provider Active NPI

Kevin L Schminke, MD

  • Internal Medicine Physician
  • Fort Dodge, IA
National Provider Identifier
1902878820
Registry record updated Dec 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
21157 Issued in IA
Practice address
804 Kenyon Rd
Suite D
Fort Dodge, IA 50501-5742
Phone
(515) 574-6141
Fax
(515) 574-6145
NPI assigned
Feb 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 21157 IA Primary

Addresses

Primary practice location

804 Kenyon Rd
Suite D
Fort Dodge, IA 50501-5742

Mailing address

804 Kenyon Rd
Suite D
Fort Dodge, IA 50501-5742
Phone (515) 574-6141

Other identifiers 3

IdentifierTypeStateIssuer
0004168MedicaidIA
110046472OtherIARR MEDICARE
17368OtherIABLUE CROSS/BLUE SHIELD

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

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260921600000",
    "number": "1902878820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 KENYON RD",
            "address_2": "SUITE D",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015742",
            "telephone_number": "515-574-6141",
            "fax_number": "515-574-6145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 KENYON RD",
            "address_2": "SUITE D",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015742",
            "telephone_number": "515-574-6141",
            "fax_number": "515-574-6145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMINKE",
        "first_name": "KEVIN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2009-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "21157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0004168",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110046472",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "17368",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Dodge, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; 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.