Active NPI
Robert John Barry, M.D.
- Dermatology Physician
- Cedar Rapids, IA
National Provider Identifier
1629051297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 16914
- Practice address
- 1030 5TH Ave SE
Cedar Rapids, IA 52403-2464 - Phone
- (319) 366-7541
- NPI assigned
- Nov 28, 2005
- Reactivated
- Oct 24, 2017
- Last updated
- Oct 24, 2017
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 16914 | IA | Primary |
| Dermatopathology Physician | 207ND0900X | 16914 | IA | |
| Clinical & Laboratory Dermatological Immunology Physician | 207NI0002X | 16914 | IA | |
| Pediatric Dermatology Physician | 207NP0225X | 16914 | IA | |
| Procedural Dermatology Physician | 207NS0135X | 16914 | IA |
Addresses
Primary practice location
1030 5TH Ave SE
Cedar Rapids, IA 52403-2464
Mailing address
1030 5TH Ave SE
Cedar Rapids, IA 52403-2464
Phone (319) 366-7541
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0055749 | Medicaid | IA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508803200000",
"number": "1629051297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1030 5TH AVE SE",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524032464",
"telephone_number": "319-366-7541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1030 5TH AVE SE",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524032464",
"telephone_number": "319-366-7541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARRY",
"first_name": "ROBERT",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-28",
"last_updated": "2017-10-24",
"deactivation_date": "2017-09-18",
"reactivation_date": "2017-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "IA",
"license": "16914",
"primary": true
},
{
"code": "207ND0900X",
"taxonomy_group": "",
"desc": "Dermatology, Dermatopathology",
"state": "IA",
"license": "16914",
"primary": false
},
{
"code": "207NI0002X",
"taxonomy_group": "",
"desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
"state": "IA",
"license": "16914",
"primary": false
},
{
"code": "207NP0225X",
"taxonomy_group": "",
"desc": "Dermatology, Pediatric Dermatology",
"state": "IA",
"license": "16914",
"primary": false
},
{
"code": "207NS0135X",
"taxonomy_group": "",
"desc": "Dermatology, Procedural Dermatology",
"state": "IA",
"license": "16914",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0055749",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cedar Rapids, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.