DR. WILLIAM J WITCIK (NPI# 1619956547) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619956547 |
| Entity Type | Individual |
| Full Name | DR. WILLIAM J WITCIK |
| Credential | M.D, |
| Practice Address |
1236 E Rusholme St Suite 300 Davenport IA 52803-2473 |
| Practice Telephone | 5633242992 |
| Practice Fax Number | 5638880499 |
| Mailing Telephone | 5633242992 |
| Mailing Fax Number | 5638880499 |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2007-11-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
29219 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 1105999 | 05 |
| Street Address |
1236 E RUSHOLME ST SUITE 300 |
| City | DAVENPORT |
| State | IA |
| Zip Code | 52803-2473 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912986837 | Prakash R Bontu | Internal Medicine | 1236 E Rusholme St, Suite 300, Davenport, IA 52803-2473 | 2006-01-10 |
| 1942606413 | Ellen Terese Holm | Nurse Practitioner | 1236 E Rusholme St, Ste 300, Davenport, IA 52803-2434 | 2014-11-11 |
| 1619228392 | Meredith Lee Hodgson | Nurse Practitioner | 1236 E Rusholme St, Suite 300, Davenport, IA 52803-2434 | 2012-09-21 |
| 1720382542 | Julie Ann Shereda | Nurse Practitioner | 1236 E Rusholme St, Suite 300, Davenport, IA 52803-2434 | 2011-01-08 |
| 1760792683 | Cynthia D Burkholder | Nurse Practitioner | 1236 E Rusholme St, Suite 300, Davenport, IA 52803-2434 | 2010-10-13 |
| 1497080709 | Srikanth Reddy Kasula | Internal Medicine | 1236 E Rusholme St, Ste 300, Davenport, IA 52803-2434 | 2009-10-05 |
| 1184957839 | Shannon M Mentzer | Nurse Practitioner | 1236 E Rusholme St, Suite 300, Davenport, IA 52803-2434 | 2009-09-14 |
| 1538353784 | Paula Jean Bryant | Nurse Practitioner | 1236 E Rusholme St, Suite 300, Davenport, IA 52803-2473 | 2007-08-30 |
| 1689724700 | Denise Elaine Antle | Clinical Nurse Specialist | 1236 E Rusholme St, Davenport, IA 52803-2473 | 2007-01-11 |
| 1871687087 | Michael Joseph Gimbel IIi | Internal Medicine | 1236 E Rusholme St, Suite 300, Davenport, IA 52803-2434 | 2006-10-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679189971 | Amber Rae Rupiper | Physician Assistant | 518 Locus Street, Davenport, IA 52803 | 2020-09-22 |
| 1558869321 | Devan Louis Depauw | Physician Assistant | 1227 East Rusholme St., Davenport, IA 52803 | 2018-01-26 |
| 1215383070 | Brittney N Hughes | Nurse Practitioner | 1228 E Rusholme Street, Suite 3020, Davenport, IA 52803 | 2016-05-11 |
| 1992138747 | Sarah Beth Schlickman | Nurse Practitioner | 1228 E Rusholme St Ste 3020, Davenport, IA 52803 | 2013-08-15 |
| 1154763845 | Leslie A Poston | Nurse Practitioner | 1228 E. Rushome Street, Mob I, Suite 2100, Davenport, IA 52803 | 2013-07-23 |
| 1083878896 | Jolene Marie Dague | Dentist | 1905 N. Main St, Davenport, IA 52803 | 2008-07-11 |
| 1952436370 | Joann C Milani | Psychologist | 1503 Brady Street, Davenport, IL 52803 | 2007-02-23 |
| 1942343579 | Lisa Clare Ploehn | Pharmacist | 129 West Locust Street, Davenport, IA 52803 | 2007-02-14 |
| 1366597957 | Cathleen Ann Clark | Social Worker | 1706 N Brady, Suite 204, Davenport, IA 52803 | 2007-01-24 |
| 1184781940 | William Burke Ltd | Durable Medical Equipment & Medical Supplies | 129 West Locust, Davenport, IA 52803 | 2007-01-02 |
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| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083693949 | Eric J Dippel | Internal Medicine | 3385 Dexter Ct Ste 100, Davenport, IA 52807-3471 | 2006-01-10 |
| 1922087857 | Nicolas W Shammas | Internal Medicine | 1236 E Rusholme St, Suite 300, Davenport, IA 52803-2473 | 2006-01-10 |
| 1114906138 | Edmund P Coyne | Internal Medicine | 1236 E Rusholme St, Suite 300, Davenport, IA 52803-2473 | 2006-01-10 |
| 1679552517 | Vijay R Rajendran | Internal Medicine | 1236 E Rusholme St, Suite 300, Davenport, IA 52803-2473 | 2006-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528314895 | Cardiovascular Consultants, LLC | Internal Medicine | 6541 Palm Valley Dr, Sioux City, IA 51106-8016 | 2012-07-24 |
| 1356677447 | Mahmoud A. Sharaf | Internal Medicine | Unitypoint Health - St Luke's, 2720 Stone Park Blvd, Sioux City, IA 51104-3734 | 2009-10-23 |
| 1902857592 | Central Iowa Hospital Corporation | Internal Medicine | 1301 Pennsylvania Avenue, Suite 100, Des Moines, IA 50316-2367 | 2006-05-16 |
| 1457344673 | Navin Gupta | Internal Medicine | 5885 Sunnybrook Dr, Suite L-200, Sioux City, IA 51106-4203 | 2005-08-23 |
| 1710307384 | Jonathan Holbrook | Internal Medicine | 200 Hawkins Dr Dept Of, Iowa City, IA 52242-1009 | 2014-04-22 |
| 1366797755 | Fayez Ahmed Siddiqui | Internal Medicine | 250 S Crescent Dr, Mason City, IA 50401-2926 | 2012-07-21 |
| 1548551237 | Des Moines Cardiology, PC | Internal Medicine | 1540 High St, Suite 102, Des Moines, IA 50309-3106 | 2011-04-28 |
| 1336376870 | Daniel M Shivapour | Internal Medicine | 411 Laurel St Ste A250, Des Moines, IA 50314-3029 | 2009-06-11 |
| 1104985589 | Heart Partners LLC | Internal Medicine | 411 Laurel St, Suite 1250, Des Moines, IA 50314-3017 | 2006-12-08 |
| 1730259987 | North Iowa Mercy Clinics | Internal Medicine | 235 8th Ave W, Cresco, IA 52136-1062 | 2006-11-08 |
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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.