Active NPI
James A Goeken, MD
- Immunopathology Physician
- Iowa City, IA
National Provider Identifier
1043208648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Immunopathology Physician
- License
- 19093
- Practice address
- 200 Hawkins Dr
Iowa City, IA 52242-1009 - Phone
- (319) 356-1966
- Fax
- (319) 384-8053
- NPI assigned
- Oct 10, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Immunopathology Physician | 207ZI0100X | 19093 | IA | Primary |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 19093 | IA |
Addresses
Primary practice location
200 Hawkins Dr
Iowa City, IA 52242-1009
Mailing address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-1966
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0224386 | Medicaid | IA | |
| 22438 | Other | IA | WELLMARK BCBS |
| 33935 | Other | IA | WELLMARK BCBS |
| 1224386 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19093 | IA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197936000000",
"number": "1043208648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 HAWKINS DR",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522421009",
"telephone_number": "319-356-1966",
"fax_number": "319-384-8053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 HAWKINS DR",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522421009",
"telephone_number": "319-356-1966",
"fax_number": "319-384-8053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOEKEN",
"first_name": "JAMES",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-10",
"last_updated": "2007-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "207ZI0100X",
"taxonomy_group": "",
"desc": "Pathology, Immunopathology",
"state": "IA",
"license": "19093",
"primary": true
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "IA",
"license": "19093",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0224386",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BCBS",
"identifier": "22438",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BCBS",
"identifier": "33935",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1224386",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Iowa City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.