Healthcare Provider Details

I. General information

NPI: 1831189232
Provider Name (Legal Business Name): KERRI JO METZGER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KERRI JO MARTIN

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 GETHMANN DR
MARSHALLTOWN IA
50158-6068
US

IV. Provider business mailing address

2001 GETHMANN DR
MARSHALLTOWN IA
50158-6068
US

V. Phone/Fax

Practice location:
  • Phone: 641-351-4128
  • Fax:
Mailing address:
  • Phone: 641-351-4128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number26923
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0168385
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: