Active NPI
Daniel J. Peasley, D.O.
- Gastroenterology Physician
- West Burlington, IA
National Provider Identifier
1821095027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 03066
- Practice address
- 1223 S Gear Ave
#205
West Burlington, IA 52655-1682 - Phone
- (319) 768-1520
- Fax
- (319) 768-1530
- NPI assigned
- Jul 1, 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 |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 03066 | IA | Primary |
Addresses
Primary practice location
1223 S Gear Ave
#205
West Burlington, IA 52655-1682
Mailing address
1223 S Gear Ave
Suite 205
West Burlington, IA 52655-1682
Phone (319) 768-1520
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 58751 | Other | IA | BLUE CROSS |
| P00325160 | Other | IA | RAILROAD MEDICARE |
| 1151191 | 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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03066 | IA | MD | Gastroenterology Physician |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Gastroenterology Physician
- West Burlington, IA
- NPI 1215979919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455580800000",
"number": "1821095027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1223 S GEAR AVE",
"address_2": "SUITE 205",
"city": "WEST BURLINGTON",
"state": "IA",
"postal_code": "526551682",
"telephone_number": "319-768-1520",
"fax_number": "319-758-1530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1223 S GEAR AVE",
"address_2": "#205",
"city": "WEST BURLINGTON",
"state": "IA",
"postal_code": "526551682",
"telephone_number": "319-768-1520",
"fax_number": "319-768-1530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEASLEY",
"first_name": "DANIEL",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-01",
"last_updated": "2016-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "IA",
"license": "03066",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "58751",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00325160",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1151191",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Burlington, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.