NPIMap

Organization Active NPI

Radiation Oncology Services of Dubuque PC

  • Radiation Oncology Physician
  • Dubuque, IA
National Provider Identifier
1669424958
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
52438 Issued in IA
Legal business name
RADIATION ONCOLOGY SERVICES OF DUBUQUE PC
Practice address
350 N Grandview Ave
Wendt Cancer Center
Dubuque, IA 52001-6388
Phone
(563) 589-2468
NPI assigned
May 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Nancy Gates Lally
Title
Office Manager
Phone
(563) 556-2097

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X 52438 IA Primary

Addresses

Primary practice location

350 N Grandview Ave
Wendt Cancer Center
Dubuque, IA 52001-6388

Mailing address

120 Bryant St
Suite 105
Dubuque, IA 52003-7403
Phone (563) 556-2097

Other identifiers 4

IdentifierTypeStateIssuer
IA0100OtherIAJOHN DEERE HEALTH PLANS
32883000MedicaidWI
0002154MedicaidIA
547180OtherWIDEAN HEALTH PLANS

National Provider Directory

National Provider Directory

Locations

120 Bryant St
Ste 105
Dubuque, IA 52003

120 Bryant St
Dubuque, IA 52003

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1669424958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 BRYANT ST",
            "address_2": "SUITE 105",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520037403",
            "telephone_number": "563-556-2097",
            "fax_number": "563-556-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N GRANDVIEW AVE",
            "address_2": "WENDT CANCER CENTER",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016388",
            "telephone_number": "563-589-2468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIATION ONCOLOGY SERVICES OF DUBUQUE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "LALLY",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "GATES",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "563-556-2097"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "IA",
            "license": "52438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE HEALTH PLANS",
            "identifier": "IA0100",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32883000",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0002154",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH PLANS",
            "identifier": "547180",
            "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 Apr 20, 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.