Active NPI
Mary Eyanson, MD
- Psychiatry Physician
- Cedar Rapids, IA
National Provider Identifier
1427018845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 20470
- Practice address
- 5264 Council St NE
Cedar Rapids, IA 52402-2471 - Phone
- (319) 398-6585
- Fax
- (319) 369-4673
- NPI assigned
- Mar 28, 2006
- Last updated
- Jul 22, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 20470 | IA | Primary |
Addresses
Primary practice location
5264 Council St NE
Cedar Rapids, IA 52402-2471
Mailing address
PO Box 1824
Cedar Rapids, IA 52406-1824
Phone (319) 369-4505
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 220921 | Medicaid | IA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20470 | IA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216684800000",
"number": "1427018845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1824",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524061824",
"telephone_number": "319-369-4505",
"fax_number": "319-369-4677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5264 COUNCIL ST NE",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524022471",
"telephone_number": "319-398-6585",
"fax_number": "319-369-4673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EYANSON",
"first_name": "MARY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-28",
"last_updated": "2008-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IA",
"license": "20470",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "220921",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cedar Rapids, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.