Active NPI
Radiologic Medical Services PC
- Diagnostic Radiology Physician
- Coralville, IA
National Provider Identifier
1023061702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- RADIOLOGIC MEDICAL SERVICES PC
- Practice address
- 2769 Heartland Dr Ste 105
Coralville, IA 52241-2732 - Phone
- (319) 545-7310
- Fax
- (319) 545-7314
- NPI assigned
- May 17, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. James A. Wiese, M.D.
- Title
- Medical Doctor
- Phone
- (319) 545-7310
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | Primary |
Addresses
Primary practice location
2769 Heartland Dr Ste 105
Coralville, IA 52241-2732
Mailing address
2771 Oakdale Blvd Ste 3
Coralville, IA 52241-9747
Phone (319) 545-7310
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0025411 | Medicaid | IA | |
| 02541 | Other | IA | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA, AZ, WA, MA, NE, NV, CA, UT, DC, FL, TX, OK, CO, OR, OH, TN, NY
Enrollment records 17
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Diagnostic Radiology Physician
- Muscatine, IA
- NPI 1659466126
O20040310000805
National Provider Directory
National Provider Directory- Tax ID family
- Radiologic Medical Serv
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Diagnostic Radiology Physician
- Muscatine, IA
- NPI 1659466126
Locations
2769 Heartland Dr
Ste 105
Coralville, IA 52241
Phone (319) 545-7300
1101 5th St
Ste 200
Coralville, IA 52241
Phone (319) 339-3629
2769 Heartland Dr
Ste 307
Coralville, IA 52241
Phone (319) 545-7310
300 W May St
Marengo, IA 52301
Phone (319) 462-8011
Practitioners & affiliated clinicians
Practitioners 42
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Diagnostic Radiology Physician
- Iowa City, IA
- NPI 1134175219
-
- Diagnostic Radiology Physician
- Coralville, IA
- NPI 1568419604
-
- Vascular & Interventional Radiology Physician
- Coralville, IA
- NPI 1790762672
Diagnostic Radiology
-
- Diagnostic Radiology Physician
- Coralville, IA
- NPI 1235455056
-
- Diagnostic Radiology Physician
- Coralville, IA
- NPI 1134173016
-
- Diagnostic Radiology Physician
- Coralville, IA
- NPI 1619256823
-
- Diagnostic Radiology Physician
- Northampton, MA
- NPI 1407893738
-
- Diagnostic Radiology Physician
- Houston, TX
- NPI 1609867464
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1694736000000",
"number": "1023061702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2771 OAKDALE BLVD STE 3",
"city": "CORALVILLE",
"state": "IA",
"postal_code": "522419747",
"telephone_number": "319-545-7310",
"fax_number": "319-626-7314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2769 HEARTLAND DR STE 105",
"city": "CORALVILLE",
"state": "IA",
"postal_code": "522412732",
"telephone_number": "319-545-7310",
"fax_number": "319-545-7314"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RADIOLOGIC MEDICAL SERVICES PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-17",
"last_updated": "2023-09-15",
"certification_date": "2023-09-15",
"status": "A",
"authorized_official_last_name": "WIESE",
"authorized_official_first_name": "JAMES",
"authorized_official_middle_name": "A.",
"authorized_official_title_or_position": "MEDICAL DOCTOR",
"authorized_official_telephone_number": "319-545-7310",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0025411",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "02541",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coralville, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.