Claibourne Ira Dungy, MD MPH

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

26805 Issued in IA

Practice address

105 E 9TH St
Coralville, IA 52241-2209

Phone

(319) 384-7333

Fax

(319) 384-6295

NPI assigned

Dec 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414368000000",
    "number": "1992782585",
    "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": "319-384-7333",
            "fax_number": "319-384-6295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 E 9TH ST",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522412209",
            "telephone_number": "319-384-7333",
            "fax_number": "319-384-6295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNGY",
        "first_name": "CLAIBOURNE",
        "middle_name": "IRA",
        "credential": "MD MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2014-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "26805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0263822",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "26382",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Providers in Coralville, IA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.