DR. DAVID ERNEST NICCUM (NPI# 1316110869) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316110869 |
| Entity Type | Individual |
| Full Name | DR. DAVID ERNEST NICCUM |
| Credential | M.D. |
| Practice Address |
640 Jackson St Ms 11502b St. Paul MN 55101-2502 |
| Mailing Address |
8170 33rd Ave S Ms 21110q Minneapolis MN 55425-0341 |
| Practice Telephone | 6512543135 |
| Practice Fax Number | 6512543048 |
| Mailing Fax Number | 6512543048 |
| Enumeration Date | 2008-04-04 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
56658 | MN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 420 Delaware St Se, Pulmonary Mmc: 276, Minneapolis, MN 554550341 | 6126240999 | 6126252174 |
| Street Address |
640 JACKSON ST MS 11502B |
| City | ST. PAUL |
| State | MN |
| Zip Code | 55101-2502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194284331 | Nora Nashawaty | Genetic Counselor, MS | 640 Jackson St, Mailstop 11101g, St. Paul, MN 55101 | 2019-03-18 |
| 1548717663 | Hanna Iona Sandstrom | Registered Nurse | 640 Jackson St, St. Paul, MN 55101 | 2016-09-07 |
| 1154630259 | Kathleen Erin O'meara | Nurse Anesthetist, Certified Registered | 640 Jackson St, St. Paul, MN 55101 | 2010-10-07 |
| 1861635435 | Keith A Moench | Physical Medicine & Rehabilitation | 640 Jackson St, Healthpartners Regions Specialty Clinics - Mc 11102d, St. Paul, MN 55101-2502 | 2009-04-13 |
| 1609021930 | Puneet Narang | Psychiatry & Neurology | 640 Jackson St, Ms 11302c Healthpartners Regions Behavioral Health, St. Paul, MN 55101-2502 | 2008-12-01 |
| 1902028996 | Jill Michelle Krokowski | Physical Therapist | 640 Jackson St, St. Paul, MN 55101 | 2007-05-02 |
| 1861618373 | Steven E Mccormack | Internal Medicine | 640 Jackson St, Healthpartners Regions Specialty Clinics - Mc 11503f, St. Paul, MN 55101-2502 | 2007-04-17 |
| 1902903693 | Sara E Erickson | Internal Medicine | 640 Jackson St, Ms 11502b Healthpartners Regions Specialty Clinics, St. Paul, MN 55101-2502 | 2006-09-17 |
| 1265542526 | Balkrishna N Jahagirdar | Internal Medicine | 640 Jackson St, Healthpartners Regions Speciality Clinics, St. Paul, MN 55101-2502 | 2006-08-30 |
| 1780644740 | Nemera F Weyessa | Family Medicine | 640 Jackson St, Mail Stop 11302c, Healthpartners Regions Behavioral Hea, St. Paul, MN 55101-2502 | 2006-03-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508480427 | El Solutions LLC | Clinic/Center | 445 Minnesota St., Ste. 1500 12, St. Paul, MN 55101 | 2020-06-05 |
| 1689211443 | Siripa Min | Nurse Anesthetist, Certified Registered | 640 Jackson Street Mail Stop 11503, St. Paul, MN 55101 | 2019-11-28 |
| 1922590488 | Diane Mcleod | Physician Assistant | Healthpartners Regions Specialty Clinics, 640 Jackson St - Mail Stop 11109e, Saint Paul, MN 55101 | 2018-05-31 |
| 1699284919 | Eric Mcgillis | Emergency Medicine | Regions Hospital - Emergency Medicine, 11102f, 640 Jackson St, St Paul, MN 55101 | 2017-09-29 |
| 1073051751 | Hannah Elizabeth Rosenthal Danielson | Physician Assistant | 640 Jackson St # Ms 11102m, Saint Paul, MN 55101 | 2017-02-02 |
| 1992182323 | Theresa Annette Cashdollar-powell | Social Worker | 640 Jackson, St Paul, MN 55101 | 2015-05-06 |
| 1770986101 | Margaret Augusta Cutter | Physician Assistant | 200 Univeristy Ave E, Saint Paul, MN 55101 | 2014-09-30 |
| 1851641419 | Lisa Rae Caturia | Occupational Therapy Assistant | 640 Jackson St, 8th Floor, St Paul, MN 55101 | 2012-09-11 |
| 1558619478 | Rph On The Go | Community/Behavioral Health | 172 E 6th Street, 704, Saint Paul, MN 55101 | 2012-08-27 |
| 1184994212 | Duyen Truong | Pharmacist | 604 Jackson Street, St. Paul, MN 55101 | 2012-01-05 |
| Find all providers in zip 55101 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548789910 | Sleepmedrx LLC | Internal Medicine | 7701 York Ave S Ste 100, Edina, MN 55435-5849 | 2017-09-16 |
| 1033354097 | Norman G Hepper | Internal Medicine | 1809 Hiawatha Ct Ne, Rochester, MN 55906-8014 | 2008-12-04 |
| 1841447083 | John Mcdougall | Internal Medicine | 1460 75th St Ne, Rochester, MN 55906-8903 | 2008-08-19 |
| 1396867909 | Abbie Lynn Begnaud | Internal Medicine | 516 Delaware Street, Clinic 6a, Umphysicians Medicine Specialties Clinic, Minneapolis, MN 55455 | 2007-04-04 |
| 1114068863 | Northwind Lung Specialists, P.a. | Internal Medicine | 3758 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2629 | 2007-02-08 |
| 1679593925 | Joan Mk Fox | Internal Medicine | 920 E 28th St # St5, Suite 700, Minneapolis, MN 55407-1139 | 2006-07-20 |
| 1871534214 | James W Leatherman | Internal Medicine | 701 Park Ave S, S1, Minneapolis, MN 55415-1623 | 2006-06-09 |
| 1649225012 | Conrad Iber | Internal Medicine | 606 24th Avenue South, Suite 106, Ump Sleep Medicine Clinic, Minneapolis, MN 55454-1437 | 2006-05-24 |
| 1831162395 | Jannica L Groom | Internal Medicine | 401 Phalen Boulevard, Mail Stop 41, St Paul, MN 55101-5302 | 2006-02-07 |
| 1194700864 | Sue Ann Ravenscraft | Internal Medicine | Park Nicollet Clinic Meadowbrook, 6490 Excelsior Blvd # W300, St Louis Park, MN 55426 | 2005-12-14 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. DAVID ERNEST NICCUM.
| 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.