Active NPI
Bob H McIntire Jr., MD
- Diagnostic Radiology Physician
- Omaha, NE
National Provider Identifier
1881616464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 12697
- Practice address
- 7831 Wakeley Plaza
Omaha, NE 68114 - Phone
- (402) 397-6344
- Fax
- (402) 397-6407
- NPI assigned
- Jul 24, 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 12697 | NE | Primary |
Addresses
Primary practice location
7831 Wakeley Plaza
Omaha, NE 68114
Mailing address
7831 Wakeley Plaza
Omaha, NE 68114
Phone (402) 397-6344
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0915611 | Other | IA | MEDICAID |
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 |
|---|---|---|---|
| 12697 | NE | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1881616464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7831 WAKELEY PLAZA",
"city": "OMAHA",
"state": "NE",
"postal_code": "68114",
"telephone_number": "402-397-6344",
"fax_number": "402-397-6407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7831 WAKELEY PLAZA",
"city": "OMAHA",
"state": "NE",
"postal_code": "68114",
"telephone_number": "402-397-6344",
"fax_number": "402-397-6407"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCINTIRE",
"first_name": "BOB",
"middle_name": "H",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NE",
"license": "12697",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID",
"identifier": "0915611",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.