Active NPI
William Richard Utley, MD
- Pediatrics Physician
- Cedar Rapids, IA
National Provider Identifier
1699768838
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 036108990
- Practice address
- 855 A Ave NE
Ste 300
Cedar Rapids, IA 52402-5057 - Phone
- (319) 368-9300
- Fax
- (319) 368-5690
- NPI assigned
- Aug 23, 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036108990 | IL | Primary |
Addresses
Primary practice location
855 A Ave NE
Ste 300
Cedar Rapids, IA 52402-5057
Mailing address
855 A Ave NE
Ste 300
Cedar Rapids, IA 52402-5057
Phone (319) 368-9300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036108990 | Medicaid | IL |
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 |
|---|---|---|---|
| 036108990 | IL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344988800000",
"number": "1699768838",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "855 A AVE NE",
"address_2": "STE 300",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524025057",
"telephone_number": "319-368-9300",
"fax_number": "319-368-5690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 A AVE NE",
"address_2": "STE 300",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524025057",
"telephone_number": "319-368-9300",
"fax_number": "319-368-5690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UTLEY",
"first_name": "WILLIAM",
"middle_name": "RICHARD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-23",
"last_updated": "2012-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036108990",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036108990",
"state": "IL"
}
],
"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 Aug 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.