1285611681 NPI number — DR. JOHN C WEBER M.D.

Table of content: DR. JOHN C WEBER M.D. (NPI 1285611681)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285611681 NPI number — DR. JOHN C WEBER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEBER
Provider First Name:
JOHN
Provider Middle Name:
C
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285611681
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/09/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 LINCOLN CIR SE
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
ORANGE CITY
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
51041-1862
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
712-737-2000
Provider Business Mailing Address Fax Number:
712-737-2115

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 LINCOLN CIR SE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
ORANGE CITY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
51041-1862
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
712-737-2000
Provider Business Practice Location Address Fax Number:
712-737-2115
Provider Enumeration Date:
12/27/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  32578 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 16674 . This is a "FIRST ADMINISTRATORS" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 21622 . This is a "SIOUX VALLEY HEALTH PLAN" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 7358 . This is a "AVERA HEALTH PLAN" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 634626 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9163865 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0117864 . This is a "MEDICA" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 0117864 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: G63099 . This is a "COVENTRY HEALTH CARE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 16674 . This is a "IOWA BANKERS" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 16674 . This is a "WELLMARK BCBS CLINIC LOCA" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 2213868 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 23661 . This is a "MIDLANDS CHOICE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 42603840551041 . This is a "WPS TRICARE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 703361026910 . This is a "PREFERRED ONE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 426038405 . This is a "CIGNA" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 45714 . This is a "BC/BS ER LOCATION" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com