Individual provider Active NPI

Paul Norman Arnold, MD

  • Ophthalmology Physician
  • Bettendorf, IA
National Provider Identifier
1467430355
Registry record updated Jun 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
23146 Issued in IA
Practice address
777 Tanglefoot LN
Bettendorf, IA 52722-1650
Phone
(563) 323-2020
Fax
(563) 328-5694
NPI assigned
Jan 3, 2006
Last updated
Jun 28, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X R4E53 MO
Ophthalmology Physician 207W00000X 23146 IA Primary
Ophthalmology Physician 207W00000X 036064392 IL

Addresses

Primary practice location

777 Tanglefoot LN
Bettendorf, IA 52722-1650

Mailing address

777 Tanglefoot LN
Bettendorf, IA 52722-1650
Phone (563) 323-2020

Other identifiers 2

IdentifierTypeStateIssuer
202073029MedicaidMO
P00450778OtherPALMETTO GBA - 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

LicenseStateTypeSpecialty
23146IAMDOphthalmology Physician
036064392ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Surgeons Associates PC Ophthalmology Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: paul.arnold.p2@direct.urologyqc.nextgenshare.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340841600000",
    "number": "1467430355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 TANGLEFOOT LN",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221650",
            "telephone_number": "563-323-2020",
            "fax_number": "563-328-5694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 TANGLEFOOT LN",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221650",
            "telephone_number": "563-323-2020",
            "fax_number": "563-328-5694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "PAUL",
        "middle_name": "NORMAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2012-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "R4E53",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IA",
            "license": "23146",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036064392",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202073029",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA - RAILROAD MEDICARE",
            "identifier": "P00450778",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.

Verify at the official NPI Registry.