NPIMap

Organization Active NPI

Family Medicine Clinic

  • Physician Assistant
  • Sibley, IA
National Provider Identifier
1992023642
Registry record updated May 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
002069 Issued in IA
Legal business name
FAMILY MEDICINE CLINIC
Practice address
600 9TH Ave N
Sibley, IA 51249-1012
Phone
(712) 754-2900
Fax
(712) 754-2634
NPI assigned
May 5, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2010

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

Authorized official

Name
Dr. Doug J Miedema, DO
Title
Partner
Phone
(712) 754-2900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363A00000X 002069 IA Primary

Addresses

Primary practice location

600 9TH Ave N
Sibley, IA 51249-1012

Mailing address

PO Box 277
Sibley, IA 51249-0277
Phone (712) 754-2900

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1273017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273017600000",
    "number": "1992023642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277",
            "city": "SIBLEY",
            "state": "IA",
            "postal_code": "512490277",
            "telephone_number": "712-754-2900",
            "fax_number": "712-754-2634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 9TH AVE N",
            "city": "SIBLEY",
            "state": "IA",
            "postal_code": "512491012",
            "telephone_number": "712-754-2900",
            "fax_number": "712-754-2634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICINE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-05",
        "last_updated": "2010-05-05",
        "status": "A",
        "authorized_official_last_name": "MIEDEMA",
        "authorized_official_first_name": "DOUG",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "712-754-2900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "002069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sibley, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2010; 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.