Active NPI
Anesthesia Intensive Care LLC
- Critical Care Medicine (Anesthesiology) Physician
- Davenport, IA
National Provider Identifier
1508387382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine (Anesthesiology) Physician
- Legal business name
- ANESTHESIA INTENSIVE CARE LLC
- Practice address
- 1227 E Rusholme St
Davenport, IA 52803-2459 - Phone
- (563) 421-1000
- NPI assigned
- Jun 30, 2017
- Last updated
- Jun 30, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Shira Black, D.O.
- Title
- Owner
- Phone
- (563) 324-8160
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Anesthesiology) Physician | 207LC0200X | NU | Primary |
Addresses
Primary practice location
1227 E Rusholme St
Davenport, IA 52803-2459
Mailing address
PO Box 2490
Davenport, IA 52809-2490
National Provider Directory
National Provider DirectoryLocations
1227 E Rusholme St
Davenport, IA 52803
Phone (563) 324-8160
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Anesthesiology Physician
- Davenport, IA
- NPI 1851377170
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498780800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1498780800000",
"number": "1508387382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2490",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528092490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1227 E RUSHOLME ST",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528032459",
"telephone_number": "563-421-1000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ANESTHESIA INTENSIVE CARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-06-30",
"last_updated": "2017-06-30",
"status": "A",
"authorized_official_last_name": "BLACK",
"authorized_official_first_name": "SHIRA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "563-324-8160",
"authorized_official_credential": "D.O."
},
"taxonomies": [
{
"code": "207LC0200X",
"taxonomy_group": "",
"desc": "Anesthesiology, Critical Care Medicine",
"state": "NU",
"license": null,
"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 Jun 30, 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.