Active NPI
Jack Isler, MD
- Anesthesiology Physician
- Sioux City, IA
National Provider Identifier
1316949233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 28904
- Practice address
- 801 5TH St
Sioux City, IA 51101-1394 - Phone
- (712) 279-2505
- NPI assigned
- Aug 11, 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 28904 | IA | Primary |
Addresses
Primary practice location
801 5TH St
Sioux City, IA 51101-1394
Mailing address
400 E 10TH St
Waconia, MN 55387-4552
Phone (952) 442-9770
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30111 | Other | IA | BLUE CROSS BLUE SHIELD |
| 3090639 | Medicaid | IA | |
| 050083667 | Other | RAILROAD MEDICARE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 28904 | IA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209427200000",
"number": "1316949233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 E 10TH ST",
"city": "WACONIA",
"state": "MN",
"postal_code": "553874552",
"telephone_number": "952-442-9770",
"fax_number": "952-442-3620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 5TH ST",
"city": "SIOUX CITY",
"state": "IA",
"postal_code": "511011394",
"telephone_number": "712-279-2505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISLER",
"first_name": "JACK",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-11",
"last_updated": "2008-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IA",
"license": "28904",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "30111",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3090639",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "050083667",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Sioux City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.