TRI-STATE MEDICAL GROUP INC NPI 1689653016

NPI Information

  • NPI: 1689653016
  • Provider Name: TRI-STATE MEDICAL GROUP INC
  • Classification: General Practice - 208D00000X
  • Entity Type: Organization
  • Address: 400 N 17TH ST
    KEOKUK, IA
    ZIP 52632
  • Phone: (319) 524-5734

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NPI Details

TRI-STATE MEDICAL GROUP INC is a general practice in Keokuk, IA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee TRI-STATE MEDICAL GROUP INC NPI is 1689653016. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

400 N 17TH ST
KEOKUK, IA
ZIP 52632-452
Phone: (319) 524-5734
Fax: (319) 524-5758

The provider's authorized official is Bryn Asbury .
The authorized official title is Office Manager and has the following contact phone number (319) 526-8789.

The enumeration date for this NPI number is 1/13/2006 and was last updated on 7/12/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208600000XSurgeryNo
22084P0804XPsychiatry & NeurologyChild & Adolescent PsychiatryNo
3208D00000XGeneral PracticeYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
156343OTHERIOWAWELLMARK BC/BS
21689653016MEDICAIDILLINOIS
31689653016MEDICARE NSCIOWA
41689653016MEDICAIDMISSOURI
50145888MEDICAIDIOWA
656343MEDICARE PINIOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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