Active NPI
Alexandria Urology P.C.
- Urology Physician
- Waterloo, IA
National Provider Identifier
1083898779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- 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, 2007
- 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. Robert Eugene Glesne, M.D.
- Title
- President
- Phone
- (319) 234-2649
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 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 DirectoryLocations
112 W Park Ln
Rm 5
Waterloo, IA 50701
Phone (319) 234-2649
Interoperability endpoints
- 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.