NPIMap

Organization Active NPI

Linn County Emergency Medicine PC

  • Emergency Medicine Physician
  • Cedar Rapids, IA
National Provider Identifier
1679521124
Registry record updated Oct 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
LINN COUNTY EMERGENCY MEDICINE PC
Practice address
701 10TH St SE
Cedar Rapids, IA 52403-1251
Phone
(319) 398-6297
Fax
(319) 398-6249
NPI assigned
May 5, 2006
Last updated
Oct 29, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2007

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

Authorized official

Name
Brian Edeker, MDNPI 1619937638
Title
Authorized Official/Physician
Phone
(319) 398-6297

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

701 10TH St SE
Cedar Rapids, IA 52403-1251

Mailing address

PO Box 5610
Cedar Rapids, IA 52406-5610
Phone (319) 369-4505

Other identifiers 1

IdentifierTypeStateIssuer
0136176MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040318000709 IA Part B Supplier - Clinic/Group Practice 9830089275 Receives reassigned benefits from 73 practitioners
1 other NPI on this enrollment
Practice locations: Cedar Rapids, IA; Hiawatha, IA; Marion, IA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 90

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.

View all 90

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": "1193616000000",
    "number": "1679521124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5610",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524065610",
            "telephone_number": "319-369-4505",
            "fax_number": "319-369-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 10TH ST SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524031251",
            "telephone_number": "319-398-6297",
            "fax_number": "319-398-6249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINN COUNTY EMERGENCY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2007-10-29",
        "status": "A",
        "authorized_official_last_name": "EDEKER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL/PHYSICIAN",
        "authorized_official_telephone_number": "319-398-6297",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0136176",
            "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 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.