Active NPI
E Torage Shivapour, MD
- Neurology Physician
- Iowa City, IA
National Provider Identifier
1699767525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 21555
- Practice address
- 200 Hawkins Dr
Iowa City, IA 52242-1009 - Phone
- (319) 356-7680
- Fax
- (319) 356-4505
- NPI assigned
- Aug 17, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 21555 | IA | Primary |
Addresses
Primary practice location
200 Hawkins Dr
Iowa City, IA 52242-1009
Mailing address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-7680
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 48831 | Other | IA | WELLMARK BCBS |
| 2195321 | Medicaid | IA |
Other names 1
- Ezzatollah Shivapour
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21555 | IA | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Hospital, Iowa City, Iowa | Current | Accepting new patients | |
| Floyd County Memorial Hospital Commission | Past | Accepting new patients |
Interoperability endpoints
- eshivapour@mic.allscriptsdirect.net
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Iowa City, IA
- NPI 1982664124
-
- Critical Access Hospital
- Charles City, IA
- NPI 1265402390
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197936000000",
"number": "1699767525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 HAWKINS DR",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522421009",
"telephone_number": "319-356-7680",
"fax_number": "319-356-4505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 HAWKINS DR",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522421009",
"telephone_number": "319-356-7680",
"fax_number": "319-356-4505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIVAPOUR",
"first_name": "E",
"middle_name": "TORAGE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-17",
"last_updated": "2007-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "IA",
"license": "21555",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BCBS",
"identifier": "48831",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2195321",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "EZZATOLLAH",
"last_name": "SHIVAPOUR",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Iowa City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.