Active NPI
Nathaniel Hargrove
- Addiction (Substance Use Disorder) Counselor
- Dubuque, IA
National Provider Identifier
1417475674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- T17059
- Practice address
- 799 Main St Ste 110
Dubuque, IA 52001-6825 - Phone
- (563) 582-3784
- NPI assigned
- Sep 7, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | T17059 | IA | Primary |
Addresses
Primary practice location
799 Main St Ste 110
Dubuque, IA 52001-6825
Mailing address
799 Main St Ste 110
Dubuque, IA 52001-6825
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T17059 | IA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1504742400000",
"number": "1417475674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "799 MAIN ST STE 110",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520016825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "799 MAIN ST STE 110",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520016825",
"telephone_number": "563-582-3784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARGROVE",
"first_name": "NATHANIEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-09-07",
"last_updated": "2017-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "IA",
"license": "T17059",
"primary": true
}
],
"identifiers": [],
"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 Sep 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.