DR. TIMOTHY DETTMER (NPI# 1275527111) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275527111 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY DETTMER |
| Credential | M.D. |
| Practice Address |
250 S Crescent Dr Mason City IA 50401-2926 |
| Practice Telephone | 6414945380 |
| Practice Fax Number | 6414945381 |
| Mailing Telephone | 6414945400 |
| Mailing Fax Number | 6414945403 |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2020-07-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 35965 | IA | Allopathic & Osteopathic Physicians |
| Street Address |
250 S CRESCENT DR |
| City | MASON CITY |
| State | IA |
| Zip Code | 50401-2926 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295737484 | Richard Elmer Rattay | Orthopaedic Surgery | 250 S Crescent Dr, Mason City, IA 50401-2926 | 2005-06-01 |
| 1154937001 | Christopher Randall | Physician Assistant | 250 S Crescent Dr, Mason City, IA 50401-2926 | 2020-09-16 |
| 1871129783 | Thomas Silva | Psychiatry & Neurology | 250 S Crescent Dr, Mason City, IA 50401-2926 | 2020-03-23 |
| 1407486194 | Heather Ann Bucklin | Nurse Practitioner | 250 S Crescent Dr, Mason City, IA 50401-2926 | 2020-01-22 |
| 1932685351 | Michele Ann Plunkett | Nurse Practitioner | 250 S Crescent Dr, Mason City, IA 50401-2926 | 2018-07-18 |
| 1285120402 | Stacey Lester | Physician Assistant | 250 S Crescent Dr, Mason City, IA 50401 | 2018-07-11 |
| 1083102933 | Colombia Esther Ptacek | Nurse Practitioner | 250 S Crescent Dr, Mason City, IA 50401-2926 | 2018-04-26 |
| 1073026274 | Jared James Johanns | Physical Therapist | 250 S Crescent Dr, Mason City, IA 50401-2926 | 2017-11-09 |
| 1639607757 | Michael David Gerber | Nurse Practitioner | 250 S Crescent Dr, Mason City, IA 50401-2926 | 2017-06-02 |
| 1255866356 | Robert Keith Giles II | Physician Assistant | 250 S Crescent Dr, Mason City, IA 50401-2926 | 2017-04-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912544123 | Handicap Village | Intermediate Care Facility, Mentally Retarded | 1140 Limestone St, Mason City, IA 50401 | 2019-12-06 |
| 1548829989 | Debra Lynn Perzynski | Counselor | 103 E State St Suite 301, Brick and Tile Building, Mason City, IA 50401 | 2019-06-10 |
| 1851858617 | Four Oaks Family and Children's Services | Psychiatric Residential Treatment Facility | 80 North Eisenhower Ave, Mason City, IA 50401 | 2019-02-27 |
| 1578055521 | Alex Jon Uhlenhopp | Optometrist | 422 S Pierce Ave Ste 1, Mason City, IA 50401 | 2018-06-05 |
| 1538672985 | Bonnie Jean Burnett | Hearing Instrument Specialist | 704 16th St. Ne, Mason City, IA 50401 | 2017-11-08 |
| 1639691009 | Jeremy Baker | Counselor | 320 N Eisenhower Avenue, Mason City, IA 50401 | 2017-07-07 |
| 1437689940 | Medi-dent, Inc. | Psychiatry & Neurology | 1050 15th St. S.w., Suite 2, Mason City, IA 50401 | 2017-06-18 |
| 1922485283 | Jamie Lynn Heard | Social Worker | 50 N. Eisenhower Ave., Mason City, IA 50401 | 2015-05-06 |
| 1558756999 | Tyler Borchardt | Specialist/Technologist | 640 South Indiana Avenue, Mason City, IA 50401 | 2015-04-02 |
| 1811339203 | Siddiq A. Khan | General Practice | 520 S. Pierce Ave. Suite 150, Mason City, IA 50401 | 2013-07-25 |
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| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770849317 | Trisha Lynn Thoma | Otolaryngology | 250 S Crescent Dr, Mason City, IA 50401-2926 | 2012-04-09 |
| 1467610196 | Henry Richard Diggelmann | Otolaryngology | 250 S Crescent Dr, Mason City, IA 50401-2926 | 2008-05-29 |
| 1083609317 | Phillip C Lee | Otolaryngology | 250 S Crescent Dr, Mason City, IA 50401-2926 | 2005-09-13 |
| 1336133818 | Vishram Jalukar | Otolaryngology | 250 S Crescent Dr, Mason City, IA 50401-2926 | 2005-09-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134658552 | Kristen Leigh Seligman | Otolaryngology | 200 Hawkins Dr, Dept of Otolaryngology, Iowa City, IA 52242-1009 | 2017-06-08 |
| 1316389653 | Koch Facial Plastic Surgery PC | Otolaryngology | 4855 Mills Civic Parkway #100, West Des Moines, IA 50265 | 2013-07-29 |
| 1770835563 | Charles Douglas Jons | Otolaryngology | 2916 Forest Hills Dr, Ames, IA 50014-3583 | 2012-10-04 |
| 1457606584 | Lindsay Jo Sturm | Otolaryngology | 2122 Leopold Dr, Ames, IA 50010-4499 | 2012-07-15 |
| 1992099402 | Stephanie Lanae Burger | Otolaryngology | 2730 Pierce St Ste 204, Sioux City, IA 51104-3764 | 2011-06-01 |
| 1245380237 | Michael Crawford | Otolaryngology | 320 Mckenzie Ave Ste 202, Council Bluffs, IA 51503-1002 | 2007-01-11 |
| 1356451421 | Kurtis David Korver | Otolaryngology | 700 Juneau Ave Se, Orange City, IA 51041 | 2006-08-30 |
| 1184682189 | Douglas R Hoisington | Otolaryngology | 2600 Westown Pkwy Ste 360, West Des Moines, IA 50266-7306 | 2006-05-02 |
| 1205893781 | Gordon Ray Johnson | Otolaryngology | 3906 Lillie Ave., Suite 1, Davenport, IA 52806-4432 | 2006-04-27 |
| 1548241037 | Craig Charles Herther | Otolaryngology | 310 N Grandview Ave, Dubuque, IA 52001-6388 | 2005-11-10 |
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| City | MASON CITY |
| Zip Code | 50401 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.