NPIMap

Organization Active NPI

Cedar Rapids OB-GYN Specialists, P.C.

  • Obstetrics & Gynecology Physician
  • Cedar Rapids, IA
National Provider Identifier
1801953096
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
CEDAR RAPIDS OB-GYN SPECIALISTS, P.C.
Practice address
788 8TH Ave SE Ste 100
Cedar Rapids, IA 52401-2106
Phone
(319) 363-2682
Fax
(319) 363-1473
NPI assigned
Jan 3, 2007
Reactivated
Nov 28, 2021
Last updated
Mar 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Authorized official

Name
Nicole Dinnel
Title
Office Manager
Phone
(319) 730-9207

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X NU Primary

Addresses

Primary practice location

788 8TH Ave SE Ste 100
Cedar Rapids, IA 52401-2106

Mailing address

1260 3Rd Ave SE
Cedar Rapids, IA 52403-4010
Phone (319) 363-2682

Other identifiers 1

IdentifierTypeStateIssuer
0217364MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040311001064 IA Part B Supplier - Clinic/Group Practice 8224927959 Receives reassigned benefits from 8 practitioners
Practice locations: Cedar Rapids, IA

National Provider Directory

National Provider Directory

Locations

1260 3rd Ave SE
Cedar Rapids, IA 52403
Phone (319) 362-7334

788 8th Ave SE
Ste 100
Cedar Rapids, IA 52401
Phone (319) 363-2682

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20991/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711324800000",
    "number": "1801953096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 3RD AVE SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524034010",
            "telephone_number": "319-363-2682",
            "fax_number": "319-363-1473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "788 8TH AVE SE STE 100",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524012106",
            "telephone_number": "319-363-2682",
            "fax_number": "319-363-1473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR RAPIDS OB-GYN SPECIALISTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "deactivation_date": "2021-10-15",
        "reactivation_date": "2021-11-28",
        "status": "A",
        "authorized_official_last_name": "DINNEL",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "319-730-9207"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0217364",
            "state": "IA"
        }
    ],
    "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 Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.