JACK C AVALOS (NPI# 1689651655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689651655 |
| Entity Type | Individual |
| Full Name | JACK C AVALOS |
| Credential | M.D. |
| Practice Address |
1410 N 4th St Clinton IA 52732-2940 |
| Mailing Address |
Po Box 2660 Waterloo IA 50704-2660 |
| Practice Telephone | 5632445642 |
| Practice Fax Number | 3192330722 |
| Mailing Telephone | 3192333044 |
| Mailing Fax Number | 3192330722 |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2010-10-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
29895 | IA | Allopathic & Osteopathic Physicians |
| Street Address |
1410 N 4TH ST |
| City | CLINTON |
| State | IA |
| Zip Code | 52732-2940 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649276437 | Prabhakar Pisipati | Psychiatry & Neurology | 1410 N 4th St, Clinton, IA 52132 | 2005-06-26 |
| 1740895853 | Ashley Renee Caes | Nurse Practitioner | 1410 N 4th St, Clinton, IA 52732-2940 | 2020-09-15 |
| 1003455296 | April Barsema | Dietitian, Registered | 1410 N 4th St, Clinton, IA 52732-2940 | 2020-01-06 |
| 1760021828 | Andrea Barnett | Health Educator | 1410 N 4th St, Clinton, IA 52732-2940 | 2020-01-06 |
| 1659913440 | Tamilselvi Periasamy | Internal Medicine | 1410 N 4th St, Clinton, IA 52732-2940 | 2019-10-13 |
| 1336614023 | Premier Physician Services Inc | Physician Assistant | 1410 N 4th St, Clinton, IA 52732-2940 | 2018-10-09 |
| 1821591454 | Iowa Emergency Services LLC | Physician Assistant | 1410 N 4th St, Clinton, IA 52732-2940 | 2018-03-09 |
| 1568987691 | Teresa R Ross | Nurse Practitioner | 1410 N 4th St, Clinton, IA 52732-2940 | 2017-08-10 |
| 1093263121 | Brandy Stinson | Nurse Anesthetist, Certified Registered | 1410 N 4th St, Clinton, IA 52732-2940 | 2016-09-19 |
| 1194117440 | Cole Asay | Nurse Anesthetist, Certified Registered | 1410 N 4th St, Clinton, IA 52732-2940 | 2015-02-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891343240 | Janet R Graf | Technician | 450 South 19th St., Clinton, IA 52732 | 2019-08-29 |
| 1346807443 | Karen Daniels | Nurse Practitioner | 2701 Frienship Trl, Apt 1001, Clinton, IA 52732 | 2019-05-23 |
| 1053835256 | Linda Karina Garcia | Physician Assistant | 1410 N Fourth St, Clinton, IA 52732 | 2017-07-29 |
| 1821528423 | Tricia Lee Grimes | Technician | 2349 Dunham St, Clinton, IA 52732 | 2017-06-15 |
| 1750822425 | Danielle Judd | Skilled Nursing Facility | 2220 N 5th St, Clinton, IA 52732 | 2017-03-15 |
| 1689047185 | Connell Family Chiropractic Pllc | Chiropractor | 1485 Main Avenue, Clinton, IA 52732 | 2015-11-05 |
| 1942619713 | Reese Raymond Petersen | Chiropractor | 2319 S 19th St, Clinton, IA 52732 | 2014-08-06 |
| 1487942298 | Wagner Pharmacy Company | Pharmacy | 1726 N. 2nd Street, Clinton, IA 52732 | 2011-07-13 |
| 1275829921 | Rebecca Plante | Pharmacist | 1309 N 2nd Street, Clinton, IA 52732 | 2011-06-21 |
| 1639318363 | Ryan P Connell | Chiropractor | 1437 Main Ave, Clinton, IA 52732 | 2009-02-19 |
| Find all providers in zip 52732 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043587629 | Clifton L Hester Jr. | Radiology | 607 E Leake St, Clinton, MS 39056-4300 | 2011-11-26 |
| 1225101173 | Palmetto Radiology, Pa | Radiology | 22725 Highway 76e, Clinton, SC 29325 | 2006-11-16 |
| 1083664395 | Palmetto Bone & Joint Pa | Radiology | 105 Physicians Park Dr, Clinton, SC 29325-7551 | 2006-05-10 |
| 1003864554 | John P Hamlin | Radiology | 100 N. 30th St, Clinton, OK 73601-3831 | 2006-05-05 |
| 1538157094 | Brian Donnelly | Radiology | 1 Dogwood Drive, Clinton, NJ 08809-0388 | 2005-10-10 |
| 1174521330 | Clinton X-ray Associates, Pa | Radiology | 409 Cooper Dr, Clinton, NC 28328-2817 | 2005-07-12 |
| 1548268709 | Terry Patrick Ginthner | Radiology | 409c Cooper Dr, Clinton, NC 28328-2817 | 2005-07-12 |
| 1568613909 | Angela Maryann Pansera | Radiology | 7801 Old Branch Ave, Ste 300, Clinton, MD 20735-1608 | 2008-10-03 |
| 1851564181 | Austin Luel Jones | Radiology | 1600 N 2nd St, Clinton, MO 64735-1192 | 2008-04-08 |
| 1205039534 | Michael Andrew Gilbert | Radiology | 1600 N 2nd St, Clinton, MO 64735-1192 | 2007-06-06 |
| Find all providers in CLINTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.