Randy Ray Poole, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7226 Issued in IA

Practice address

15 N Van Buren St
Iowa City, IA 52245-2452

Phone

(319) 337-2193

NPI assigned

Aug 2, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609883578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 N VAN BUREN ST",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522452452",
            "telephone_number": "319-337-2193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 N VAN BUREN ST",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522452452",
            "telephone_number": "319-337-2193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOLE",
        "first_name": "RANDY",
        "middle_name": "RAY",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "7226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Glen Pomeroy, DNP, CRNA
• Rakesh Ponnapureddy
• Abirami Ponnusamy
• Catherine Ponto
• Debra S Poole, PA-C
• Emmarie Febe Poolman, ACNPC-AG
• Kathryn Perdaems Poolman
• Asif Poonja
• Kittika Poonsombudlert, MD
• Curtis T Poor, MD

• General Practice Dentistry in Iowa City, IA
• Providers in Iowa City, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.