NPIMap

Organization Active NPI

Dubuque Radiological Associates, PC

  • Diagnostic Radiology Physician
  • Dubuque, IA
National Provider Identifier
1619925260
Registry record updated Feb 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
DUBUQUE RADIOLOGICAL ASSOCIATES, PC
Practice address
350 N Grandview Ave
Dubuque, IA 52001-6392
Phone
(563) 582-1881
Fax
(563) 589-2491
NPI assigned
May 5, 2006
Last updated
Feb 20, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2014

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

Authorized official

Name
Kirby Clark, M.D.
Title
President
Phone
(563) 556-6895

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

350 N Grandview Ave
Dubuque, IA 52001-6392

Mailing address

998 Fremont Ave Ste L5
PO Box 1655
Dubuque, IA 52003-0300
Phone (563) 556-6895

Other identifiers 7

IdentifierTypeStateIssuer
0145417MedicaidIA
30951OtherIAWELLMARK FINLEY
04719OtherIAWELLMARK OFFICE LOCATION
4323751OtherILBLUE SHIELD
32663OtherIAWELLMARK MAQUOKETA LOCATI
0147348MedicaidIA
32651500MedicaidWI

National Provider Directory

National Provider Directory

Locations

1550 University Ave
Dubuque, IA 52001
Phone (563) 589-4899

4170 Pennsylvania Ave
Ste 2
Dubuque, IA 52002
Phone (563) 588-8060

998 Fremont Ave
Ste L5
Dubuque, IA 52003
Phone (563) 583-8281

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392854400000",
    "number": "1619925260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "998 FREMONT AVE STE L5",
            "address_2": "PO BOX 1655",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520030300",
            "telephone_number": "563-556-6895",
            "fax_number": "563-556-3618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N GRANDVIEW AVE",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016392",
            "telephone_number": "563-582-1881",
            "fax_number": "563-589-2491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUBUQUE RADIOLOGICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2014-02-20",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "KIRBY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "563-556-6895",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0145417",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK FINLEY",
            "identifier": "30951",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK  OFFICE LOCATION",
            "identifier": "04719",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "4323751",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK MAQUOKETA LOCATI",
            "identifier": "32663",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0147348",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32651500",
            "state": "WI"
        }
    ],
    "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 Feb 20, 2014; 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.