Active NPI
Edmond E O'Neill, M.D.
- Surgery Physician
- Dubuque, IA
National Provider Identifier
1952355273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 20220
- Practice address
- 1000 Langworthy St
Dubuque, IA 52001-7313 - Phone
- (563) 584-3450
- Fax
- (563) 584-3171
- NPI assigned
- May 20, 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 20220 | IA | Primary |
| Surgery Physician | 208600000X | 036-085286 | IA | |
| Surgery Physician | 208600000X | 36216 | WI | |
| Surgery Physician | 208600000X | 036085286 | IL |
Addresses
Primary practice location
1000 Langworthy St
Dubuque, IA 52001-7313
Mailing address
1500 Associates Dr
Dubuque, IA 52002-2201
Phone (563) 584-4100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0182071 | 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 |
|---|---|---|---|
| 036-085286 | IA | MD | Surgery Physician |
| 20220 | IA | MD | Surgery Physician |
| 036085286 | IL | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447286400000",
"number": "1952355273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 ASSOCIATES DR",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520022201",
"telephone_number": "563-584-4100",
"fax_number": "563-584-4110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 LANGWORTHY ST",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520017313",
"telephone_number": "563-584-3450",
"fax_number": "563-584-3171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'NEILL",
"first_name": "EDMOND",
"middle_name": "E",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-20",
"last_updated": "2015-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IA",
"license": "20220",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IA",
"license": "036-085286",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WI",
"license": "36216",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": "036085286",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0182071",
"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 Nov 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.