Active NPI
Robert M Welshons, P.A.C.
- Physician Assistant
- Waterloo, IA
National Provider Identifier
1184611014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 001246
- Practice address
- 2055 Kimball Ave
Suite 101
Waterloo, IA 50702-5047 - Phone
- (319) 272-2112
- Fax
- (319) 272-2107
- NPI assigned
- Oct 5, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 001246 | IA | Primary |
Addresses
Primary practice location
2055 Kimball Ave
Suite 101
Waterloo, IA 50702-5047
Mailing address
2055 Kimball Ave
Suite 101
Waterloo, IA 50702-5047
Phone (319) 272-2112
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001246 | IA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328140800000",
"number": "1184611014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2055 KIMBALL AVE",
"address_2": "SUITE 101",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507025047",
"telephone_number": "319-272-2112",
"fax_number": "319-272-2107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2055 KIMBALL AVE",
"address_2": "SUITE 101",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507025047",
"telephone_number": "319-272-2112",
"fax_number": "319-272-2107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELSHONS",
"first_name": "ROBERT",
"middle_name": "M",
"credential": "P.A.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-05",
"last_updated": "2012-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IA",
"license": "001246",
"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 Feb 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.