Individual provider Active NPI

Jaquanese Douglas, RT(R)

  • Radiography Radiologic Technologist
  • Iowa City, IA
National Provider Identifier
1801509385
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiography Radiologic TechnologistTaxonomy code 2471C3402X
Practice address
601 Highway 6 W
Iowa City, IA 52246-2209
Phone
(319) 338-0581
NPI assigned
Dec 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiography Radiologic Technologist 2471C3402X GA Primary

Addresses

Primary practice location

601 Highway 6 W
Iowa City, IA 52246-2209

Mailing address

505 Garden Wood Dr Apt 505
Atlanta, GA 30349-8524
Phone (706) 593-9804

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1672272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1801509385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 GARDEN WOOD DR APT 505",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303498524",
            "telephone_number": "706-593-9804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 HIGHWAY 6 W",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522462209",
            "telephone_number": "319-338-0581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "JAQUANESE",
        "credential": "RT(R)",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-29",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 29, 2022; 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.