KIRK D DIMITRIS (NPI# 1518020429) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518020429 |
| Entity Type | Individual |
| Full Name | KIRK D DIMITRIS |
| Credential | MD |
| Practice Address |
1650 S 41st St Manitowoc WI 54220-7316 |
| Mailing Address |
Po Box 2290 Manitowoc WI 54221-2290 |
| Practice Telephone | 9203205241 |
| Mailing Telephone | 9203202591 |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-10-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 52604-020 | WI | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | ME100953 | FL | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | 35.085490 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | BCBS | 1518020429 | 01 |
| WI | 207X00000X | 05 | |
| WI | CHAMPUS | 390806395003 | 01 |
| Street Address |
1650 S 41ST ST |
| City | MANITOWOC |
| State | WI |
| Zip Code | 54220-7316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548260060 | Jonathan A Snellgrove | Podiatrist | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2005-07-27 |
| 1700484326 | Kora Tesarik | Physical Therapy Assistant | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2020-10-15 |
| 1699386367 | Nicole Sixel | Nurse Practitioner | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2020-08-14 |
| 1891320735 | June C Magnussen | Nurse Practitioner | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2020-03-11 |
| 1063062271 | Kelly Marie Liebergen | Speech-Language Pathologist | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2019-09-19 |
| 1235601709 | Kara Danielle Mcclone | Physician Assistant | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2018-12-21 |
| 1770074809 | Andrea B Zahn | Physical Therapist | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2018-05-24 |
| 1790274454 | Maria E Lensmire | Physical Therapy Assistant | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2018-05-08 |
| 1053835207 | Nicole Drew | Physical Therapist | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2017-07-31 |
| 1740729714 | Margaret Huebbe | Speech-Language Pathologist | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2017-02-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235614843 | Katherine Borchardt | Registered Nurse | 3520 Foxfire Ct, Manitowoc, WI 54220 | 2018-09-28 |
| 1285128215 | Aurora Pharmacy Inc | Pharmacy | 3509 Dewey Street, Suite 100, Manitowoc, WI 54220 | 2018-06-22 |
| 1477937274 | Baycare Clinic LLP | Psychiatry & Neurology | 4801 Expo Drive, Manitowoc, WI 54220 | 2015-07-13 |
| 1831593821 | Brittany Camille Schultz | Acupuncturist | 2510 Washington Street, Manitowoc, WI 54220 | 2014-10-20 |
| 1710311261 | Brian E Weitz | Physical Therapy Assistant | 960 S. Rapids Rd., Manitowoc, WI 54220 | 2013-09-01 |
| 1134499080 | Total Renal Care Inc | Clinic/Center | 3303 Dewey St, Manitowoc, WI 54220 | 2012-01-10 |
| 1679858534 | Lisa M Noworatzky | Marriage & Family Therapist | 926 S. 8th St., Manitowoc, WI 54220 | 2011-10-11 |
| 1306177225 | Cynthia Fay Wenzel | Licensed Practical Nurse | 915 East Linden Avenue, Manitowoc, WI 54220 | 2010-01-15 |
| 1851550628 | Roundys Supermarkets Inc | Pharmacy | 3300 Calumet Ave, Manitowoc, WI 54220 | 2008-06-05 |
| 1851566079 | Jennifer C Mcwilliams | Registered Nurse | 1004 Nth 8th St., Manitowoc, WI 54220 | 2008-04-29 |
| Find all providers in zip 54220 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629184932 | Barry V Bast | Orthopaedic Surgery | 7326 Cr Jj, Manitowoc, WI 54220-7316 | 2006-08-21 |
| 1699744730 | Jonathon Charles Henry | Orthopaedic Surgery | 501 N 10th St, Manitowoc, WI 54220-4039 | 2006-03-14 |
| 1437312774 | David King Mikolyzk | Orthopaedic Surgery | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2008-07-07 |
| 1972764561 | Thomas Joseph Sylvester | Orthopaedic Surgery | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2008-06-17 |
| 1982720231 | John Adam Hamilton | Orthopaedic Surgery | 501 N 10th St, Manitowoc, WI 54220 | 2007-03-21 |
| 1164513123 | Joseph Edgar Trader | Orthopaedic Surgery | 501 N 10th St, Manitowoc, WI 54220-4039 | 2006-09-27 |
| 1063503035 | David James Kuester | Orthopaedic Surgery | 501 N 10th St, Manitowoc, WI 54220-4039 | 2006-09-27 |
| 1407947450 | Craig Ladd Olson | Orthopaedic Surgery | 501 N 10th St, Manitowoc, WI 54220-4039 | 2006-09-27 |
| 1609967637 | Carl Alan Diraimondo | Orthopaedic Surgery | 501 N 10th St, Manitowoc, WI 54220-4039 | 2006-09-27 |
| 1942210729 | Ryan M Dopirak | Orthopaedic Surgery | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2006-08-08 |
| Find all providers in MANITOWOC | ||||
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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.