DJ Marc Cardinal, MD PA

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

DJ MARC CARDINAL, MD PA

Practice address

98 Poplar St
Blackfoot, ID 83221-1758

Phone

(208) 785-3810

NPI assigned

Oct 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

DJ Marc Cardinal, MD

Title

President

Phone

(208) 785-3810

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alyssa May Jack, PA-C

  • Physician Assistant
  • Idaho Falls, ID
  • NPI 1598357436
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319068800000",
    "number": "1053493809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2896",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834032896",
            "telephone_number": "208-523-4906",
            "fax_number": "208-523-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 POPLAR ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211758",
            "telephone_number": "208-785-3810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DJ MARC CARDINAL, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2011-10-20",
        "status": "A",
        "authorized_official_last_name": "CARDINAL",
        "authorized_official_first_name": "DJ",
        "authorized_official_middle_name": "MARC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-785-3810",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "DG2308",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806651100",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dawn Enterprises Inc.
• Dennis N. Marshall, O.D., P.a.
• Jameson Cade Devine
• Gordon E Dixon Jr., DO
• Vanessa Dixon, LMSW
• Susan Doran, LSW
• Brady J Dowding, PHARM.D. RPH
• Frederick George Downard, O.D.
• Christopher Duke, LAT, ATC
• Shawna Durbin

• Diagnostic Radiology Physician in Blackfoot, ID
• Providers in Blackfoot, ID by specialty
• Diagnostic Radiology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.