1376510883 NPI number — ARTEMIO CAPILI SANTIAGO MD

Table of content: ARTEMIO CAPILI SANTIAGO MD (NPI 1376510883)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376510883 NPI number — ARTEMIO CAPILI SANTIAGO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SANTIAGO
Provider First Name:
ARTEMIO
Provider Middle Name:
CAPILI
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1376510883
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/30/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5409 AVE O
Provider Second Line Business Mailing Address:
SUITE 107
Provider Business Mailing Address City Name:
FORT MADISON
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52627
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
319-372-7270
Provider Business Mailing Address Fax Number:
319-372-7279

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5409 AVE O
Provider Second Line Business Practice Location Address:
SUITE 107
Provider Business Practice Location Address City Name:
FORT MADISON
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52627-9601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-372-7270
Provider Business Practice Location Address Fax Number:
319-372-7279
Provider Enumeration Date:
03/02/2006

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: 207R00000X , with the licence number:  20740 , 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: 13885 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 421324159 . This is a "HUMANA GOLD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 421324159 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 42132415901 . This is a "JOHN DEERE HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 421324159 . This is a "WAUSAU" identifier . This identifiers is of the category "OTHER".
  • Identifier: 421324159 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 421324159 . This is a "STANDARD LIFE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 421324159 . This is a "APWU" identifier . This identifiers is of the category "OTHER".
  • Identifier: 793111317 . This is a "PALMETTO GBA" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 421324159 . This is a "BANKERS LIFE & CASUALTY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 421324159 . This is a "NATL ASSC LETTER CARRIERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 421324159 . This is a "TRI CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 13885 . This is a "WELLMARK BCBS IA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 421324159 . This is a "SECURE HORIZONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 421324159T . This is a "BLUE SHIELD OF ILLINOIS" identifier . This identifiers is of the category "OTHER".




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