Individual provider Active NPI

Mark Raymond Knabel, M.D.

  • Specialist
  • Dubuque, IA
National Provider Identifier
1598732489
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
22086 Issued in IA
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

Updated by the provider on Dec 12, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0263558MedicaidIA
1598732489OtherIANPI
386682104OtherIAILLINOIS PUBLIC AID
421462387OtherIAMISCELLANEOUS INSURANCE
13070OtherIADEAN HEALTHCARE
IA0107OtherIAJOHN DEERE HEALTHCARE
55736OtherIAWELLMARK 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

LicenseStateTypeSpecialty
22086IAMDSpecialist
24706-20WIMDDermatology 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.

Verify at the official NPI Registry.