Organization Active NPI

Alexandria Urology P.C.

  • Urology Physician
  • Waterloo, IA
National Provider Identifier
1083898779
Registry record updated Dec 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
ALEXANDRIA UROLOGY P.C.
Practice address
112 Park Lane
Room 5
Waterloo, IA 50701
Phone
(319) 234-2649
Fax
(319) 233-2430
NPI assigned
Dec 18, 2007
Last updated
Dec 18, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2007

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

Authorized official

Name
Dr. Robert Eugene Glesne, M.D.
Title
President
Phone
(319) 234-2649

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

112 Park Lane
Room 5
Waterloo, IA 50701

Mailing address

112 Park Lane
Waterloo, IA 50701-1514
Phone (319) 234-2649

National Provider Directory

National Provider Directory

Locations

112 W Park Ln
Rm 5
Waterloo, IA 50701
Phone (319) 234-2649

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GFAAAA

NPI Registry JSON

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197936000000",
    "number": "1083898779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 PARK LANE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507011514",
            "telephone_number": "319-234-2649",
            "fax_number": "319-233-2430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 PARK LANE",
            "address_2": "ROOM 5",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "50701",
            "telephone_number": "319-234-2649",
            "fax_number": "319-233-2430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEXANDRIA UROLOGY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-18",
        "last_updated": "2007-12-18",
        "status": "A",
        "authorized_official_last_name": "GLESNE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "319-234-2649",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, 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.

Verify at the official NPI Registry.