Active NPI
Mark Raymond Knabel, M.D.
- Specialist
- Dubuque, IA
National Provider Identifier
1598732489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 22086
- Practice address
- 1500 Delhi St
Ste 4100
Dubuque, IA 52001-6358 - Phone
- (563) 557-5900
- Fax
- (563) 557-5905
- NPI assigned
- Mar 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 22086 | IA | Primary |
| Dermatology Physician | 207N00000X | 24706-20 | WI |
Addresses
Primary practice location
1500 Delhi St
Ste 4100
Dubuque, IA 52001-6358
Mailing address
1500 Delhi St Ste 4100
Dubuque, IA 52001-6362
Phone (563) 557-5900
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0263558 | Medicaid | IA | |
| 1598732489 | Other | IA | NPI |
| 386682104 | Other | IA | ILLINOIS PUBLIC AID |
| 421462387 | Other | IA | MISCELLANEOUS INSURANCE |
| 13070 | Other | IA | DEAN HEALTHCARE |
| IA0107 | Other | IA | JOHN DEERE HEALTHCARE |
| 55736 | Other | IA | WELLMARK BCBS NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22086 | IA | MD | Specialist |
| 24706-20 | WI | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355270400000",
"number": "1598732489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 DELHI ST STE 4100",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520016362",
"telephone_number": "563-557-5900",
"fax_number": "563-557-5905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 DELHI ST",
"address_2": "STE 4100",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520016358",
"telephone_number": "563-557-5900",
"fax_number": "563-557-5905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNABEL",
"first_name": "MARK",
"middle_name": "RAYMOND",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-01",
"last_updated": "2012-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "IA",
"license": "22086",
"primary": true
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "WI",
"license": "24706-20",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0263558",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1598732489",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ILLINOIS PUBLIC AID",
"identifier": "386682104",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MISCELLANEOUS INSURANCE",
"identifier": "421462387",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEAN HEALTHCARE",
"identifier": "13070",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE HEALTHCARE",
"identifier": "IA0107",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BCBS NUMBER",
"identifier": "55736",
"state": "IA"
}
],
"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 Dec 12, 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.