NPIMap

Organization Active NPI

Plastic Surgery Center, P.C.

  • Plastic Surgery Physician
  • Davenport, IA
National Provider Identifier
1356527477
Registry record updated Feb 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
33897 Issued in IA
Legal business name
PLASTIC SURGERY CENTER, P.C.
Practice address
3385 Dexter CT
Suite 115
Davenport, IA 52807-3471
Phone
(563) 359-4777
Fax
(563) 359-4781
NPI assigned
Jan 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2008

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

Authorized official

Name
Dr. James Francis Paul, MD, DDS, MSNPI 1467431213
Title
Owner
Phone
(563) 359-4777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X 33897 IA
Oral & Maxillofacial Surgery (D.M.D.)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 204E00000X 07454 IA
Plastic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208200000X 33897 IA Primary

Addresses

Primary practice location

3385 Dexter CT
Suite 115
Davenport, IA 52807-3471

Mailing address

3385 Dexter CT
Suite 115
Davenport, IA 52807-3471
Phone (563) 359-4777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080218000157 IA Part B Supplier - Clinic/Group Practice 2860575644 Receives reassigned benefits from 1 practitioner
Practice locations: Davenport, IA; Bettendorf, IA

National Provider Directory

National Provider Directory

Locations

3385 Dexter Ct
Ste 115
Davenport, IA 52807
Phone (563) 359-4777

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201824000000",
    "number": "1356527477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3385 DEXTER CT",
            "address_2": "SUITE 115",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073471",
            "telephone_number": "563-359-4777",
            "fax_number": "563-359-4781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3385 DEXTER CT",
            "address_2": "SUITE 115",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073471",
            "telephone_number": "563-359-4777",
            "fax_number": "563-359-4781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGERY CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-18",
        "last_updated": "2008-02-01",
        "status": "A",
        "authorized_official_last_name": "PAUL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "563-359-4777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, DDS, MS"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "IA",
            "license": "33897",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "IA",
            "license": "07454",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "IA",
            "license": "33897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.