Kousei Ishigami, MD – Body Imaging Physician

Key facts

NPI: 1811253552
Entity type: Individual (NPI type 1)
Primary specialty: Body Imaging Physician 2085B0100X
License: SP-211 (IA)
Practice address: 200 Hawkins Dr
Iowa City, IA 52242-1009
Phone: (319) 353-7123
Fax: (319) 356-2220
NPI assigned: Apr 6, 2012
Sex: Male
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
SP-211	IA	MD	Body Imaging Physician

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Body Imaging Physician	2085B0100X	SP-211	IA	Yes

Addresses

Primary practice location

200 Hawkins Dr
Iowa City, IA 52242-1009

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 353-7123

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 6, 2012.

{
    "created_epoch": "1333670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333670400000",
    "number": "1811253552",
    "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": "319-353-7123",
            "fax_number": "319-356-2220"
        },
        {
            "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": "319-353-7123",
            "fax_number": "319-356-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISHIGAMI",
        "first_name": "KOUSEI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-06",
        "last_updated": "2012-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "IA",
            "license": "SP-211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

All providers in Iowa City, IA · Body Imaging Physician in Iowa

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 6, 2012. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.