Individual provider Active NPI

Teresa Eckhart, M.D.

  • Obstetrics & Gynecology Physician
  • Dubuque, IA
National Provider Identifier
1154328235
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
21918 Issued in IA
Practice address
1500 Delhi St
Suite 3100
Dubuque, IA 52001-6358
Phone
(563) 557-5959
Fax
(563) 557-5950
NPI assigned
Jul 5, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 21918 IA Primary

Addresses

Primary practice location

1500 Delhi St
Suite 3100
Dubuque, IA 52001-6358

Mailing address

1500 Delhi St
Suite 3100
Dubuque, IA 52001-6358
Phone (563) 557-5959

Other identifiers 3

IdentifierTypeStateIssuer
31623600MedicaidWI
0180377043MedicaidIL
1182139MedicaidIA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21918IAMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1154328235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 DELHI ST",
            "address_2": "SUITE 3100",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016358",
            "telephone_number": "563-557-5959",
            "fax_number": "563-557-5950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 DELHI ST",
            "address_2": "SUITE 3100",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016358",
            "telephone_number": "563-557-5959",
            "fax_number": "563-557-5950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKHART",
        "first_name": "TERESA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IA",
            "license": "21918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31623600",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0180377043",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1182139",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; 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.