A. B. Degala, M.D.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

A. B. DEGALA, M.D.

Practice address

1603 Morgan St
Suite 5
Keokuk, IA 52632-3433

Phone

(319) 524-8211

NPI assigned

Feb 1, 2007

Last updated

May 9, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Antonio Banzon Degala, M.D.

Title

Owner

Phone

(319) 524-8211

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210291200000",
    "number": "1659419950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 MORGAN ST",
            "address_2": "SUITE 5",
            "city": "KEOKUK",
            "state": "IA",
            "postal_code": "526323433",
            "telephone_number": "319-524-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 MORGAN ST",
            "address_2": "SUITE 5",
            "city": "KEOKUK",
            "state": "IA",
            "postal_code": "526323433",
            "telephone_number": "319-524-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A. B. DEGALA, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2008-05-09",
        "status": "A",
        "authorized_official_last_name": "DEGALA",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_middle_name": "BANZON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-524-8211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "07398",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0073981",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1598768863",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; 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.