Individual provider Active NPI

Jordan Carl Imoehl, M.D.

  • Emergency Medicine Physician
  • Madison, WI
National Provider Identifier
1699123935
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
68529 Issued in WI
Practice address
600 Highland Ave
Madison, WI 53792-0001
Phone
(608) 262-2398
Fax
(608) 262-9999
NPI assigned
May 26, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 68529 WI Primary

Addresses

Primary practice location

600 Highland Ave
Madison, WI 53792-0001

Mailing address

6530 Scarlet Rose Cir SW
Cedar Rapids, IA 52404-1264

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181105002810 WI Practitioner - Emergency Medicine 4981997178 Reassigns benefits to 1 organization
I20200605001637 IA Practitioner - Emergency Medicine 4981997178 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Iowa, RJ & L Carver College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Johnson County Emergency Medicine PLCGroup PAC ID 6901231810, 29 clinicians

Practice addresses (Care Compare)

1195 Boyson Rd
Suite 101
Hiawatha, IA 52233-2218
Phone (319) 832-3950

500 E Market St
Iowa City, IA 52245-2633
Phone (319) 339-0300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
68529WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Wisconsin Emergency Associates SC Emergency Medicine CurrentSince Nov 1, 2018 Accepting new patients
Linn County Emergency Medicine PC Emergency Medicine Current Accepting new patients
Linn County Emergency Medicine PC Emergency Medicine CurrentSince Mar 15, 2020 Accepting new patients
Johnson County Emergency Medicine, PLC Emergency Medicine CurrentSince Mar 15, 2020 Accepting new patients

Locations

701 10th St SE
Cedar Rapids, IA 52403
Phone (319) 398-6011

1195 Boyson Rd
Ste 101
Hiawatha, IA 52233
Phone (319) 832-3950

500 E Market St
Iowa City, IA 52245
Phone (319) 339-0300

999 35th St
Marion, IA 52302

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1699123935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6530 SCARLET ROSE CIR SW",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524041264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537920001",
            "telephone_number": "608-262-2398",
            "fax_number": "608-262-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMOEHL",
        "first_name": "JORDAN",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-26",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "68529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.