Active NPI
Richard John Fairley, M.D.
- Internal Medicine Physician
- Dubuque, IA
National Provider Identifier
1801862552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 26557
- Practice address
- 1515 Delhi St
Ste 100
Dubuque, IA 52001-6320 - Phone
- (563) 557-9111
- Fax
- (563) 589-4046
- NPI assigned
- Feb 23, 2006
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 26557 | IA | Primary |
Addresses
Primary practice location
1515 Delhi St
Ste 100
Dubuque, IA 52001-6320
Mailing address
1515 Delhi St
Ste 100
Dubuque, IA 52001-6320
Phone (563) 557-9111
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31478600 | Medicaid | WI | |
| 0054981 | Medicaid | IA |
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 |
|---|---|---|---|
| 26557 | IA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192665600000",
"number": "1801862552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 DELHI ST",
"address_2": "STE 100",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520016320",
"telephone_number": "563-557-9111",
"fax_number": "563-589-4046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 DELHI ST",
"address_2": "STE 100",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520016320",
"telephone_number": "563-557-9111",
"fax_number": "563-589-4046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIRLEY",
"first_name": "RICHARD",
"middle_name": "JOHN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-23",
"last_updated": "2007-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IA",
"license": "26557",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31478600",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0054981",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dubuque, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 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.