NICHOLAS OMDAHL (NPI# 1841211950) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841211950 |
| Entity Type | Individual |
| Full Name | NICHOLAS OMDAHL |
| Credential | MD |
| Practice Address |
3803 Spring St Suite 600 Racine WI 53405-1660 |
| Practice Telephone | 2626878312 |
| Practice Fax Number | 2626878796 |
| Mailing Telephone | 2626878312 |
| Mailing Fax Number | 2626878796 |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2010-09-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
20631 | WI | Allopathic & Osteopathic Physicians |
| Street Address |
3803 SPRING ST SUITE 600 |
| City | RACINE |
| State | WI |
| Zip Code | 53405-1660 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508896671 | Iftekhar Bader | Internal Medicine | 3803 Spring St, Ste 600, Racine, WI 53405-1660 | 2006-07-04 |
| 1194972711 | Grace Serrano Damrow | Nurse Practitioner | 3803 Spring St, Suite 600, Racine, WI 53405-1660 | 2008-08-26 |
| 1902015167 | Joel William Niebuhr | Internal Medicine | 3803 Spring St, Suite 600, Racine, WI 53405 | 2007-05-22 |
| 1265655732 | Jennifer A Niederstadt | Nurse Practitioner | 3803 Spring St, Suite 410, Racine, WI 53405-1660 | 2007-04-11 |
| 1710051271 | Michael L. Papp | Internal Medicine | 3803 Spring St, Racine, WI 53405-3594 | 2006-11-17 |
| 1316957491 | Suzana Zamecnik | Nurse Practitioner | 3803 Spring St, Suite 410, Racine, WI 53405-1660 | 2006-08-09 |
| 1851301675 | James Tierney | Internal Medicine | 3803 Spring St, Suite 410, Racine, WI 53405-1660 | 2006-08-08 |
| 1841200383 | Kaye-eileen Willard | Internal Medicine | 3803 Spring St, Suite 410, Racine, WI 53405-1660 | 2006-08-08 |
| 1972512895 | Ranganatharao Sriram | Internal Medicine | 3803 Spring St, Suite 410, Racine, WI 53405-1660 | 2006-08-07 |
| 1346264223 | Howard W. Short | Internal Medicine | 3803 Spring St, Suite 410, Racine, WI 53405-1660 | 2006-07-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609407923 | Anita Kathy Nykaza | Dietitian, Registered | 3805 A Suite 311, Racine, WI 53405 | 2020-01-27 |
| 1023666062 | Shawn L Drulia | Physician Assistant | 3805 Spring St #320, Racine, WI 53405 | 2019-09-03 |
| 1235627720 | Oxygen One, Inc. | Durable Medical Equipment & Medical Supplies | 3805a Spring Street, Suite 210, Racine, WI 53405 | 2018-04-30 |
| 1356838650 | Melissa Metzger | Psychologist | 2340 Mohr Ave, Racine, WI 53405 | 2018-04-23 |
| 1689029217 | Melissa Ileen Swainston | Nurse Practitioner | 3803 Spring St., Suite Number 410, Racine, WI 53405 | 2016-05-02 |
| 1215305487 | Denetta Lauraelaine Flowers | Licensed Practical Nurse | 4311 Durand Ave., #104, Mt.pleasant, WI 53405 | 2015-09-04 |
| 1841675204 | Colleen Koderca | Registered Nurse | 3317-meachem Rd, Racine, WI 53405 | 2015-07-28 |
| 1790102986 | Georges Wakim | Specialist/Technologist | 3811 Spring St., Suite 102, Racine, WI 53405 | 2014-03-25 |
| 1982021176 | Matthew F Patzke | Specialist/Technologist | 3811 Spring Street Suite 102, Racine, WI 53405 | 2014-03-25 |
| 1073930269 | Jessica Geisler | Specialist/Technologist | 3811 Spring Street Suite #102, Racine, WI 53405 | 2014-03-25 |
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| 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 |
|---|---|---|---|---|
| 1508896671 | Iftekhar Bader | Internal Medicine | 3803 Spring St, Ste 600, Racine, WI 53405-1660 | 2006-07-04 |
| 1336304542 | William J. Little Jr. | Internal Medicine | 904 State St, Racine, WI 53404-3346 | 2008-07-28 |
| 1609898071 | Steven Johnson | Internal Medicine | 3803 Spring St, Suite 600, Racine, WI 53405-1660 | 2006-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790307080 | Rihawi Md Sc | Internal Medicine | 2801 W Kinnickinnic River Pkwy Ste 445, Milwaukee, WI 53215-3669 | 2020-05-11 |
| 1194377747 | Samuel Lerush Butler | Internal Medicine | 2314 Dahlk Cir, Verona, WI 53593-8846 | 2019-07-14 |
| 1750810784 | Marjorie F Maxwell | Internal Medicine | 2823 N University Dr Apt 104, Waukesha, WI 53188-1428 | 2017-06-04 |
| 1326477233 | Aasim Mohammed | Internal Medicine | 116 N Dodge St Ste 201, Burlington, WI 53105-1963 | 2013-11-01 |
| 1275895336 | Deborah Jean Mcnear | Internal Medicine | 11516 N Justin Dr, Mequon, WI 53092-2866 | 2012-06-13 |
| 1033422860 | Sanjeevkumar Ashok Patel | Internal Medicine | 2500 E Capitol Dr Ste 1700, Appleton, WI 54911-8735 | 2010-07-21 |
| 1124284054 | David Y Rosenzweig | Internal Medicine | 6236 Upper Pkwy N, Wauwatosa, WI 53213-2430 | 2008-07-30 |
| 1033389473 | Pamela Aird Wilson | Internal Medicine | 6001 Galley Ct, Madison, WI 53705-4429 | 2008-02-29 |
| 1699835256 | Stuart A Levy | Internal Medicine | 9509 N Wakefield Ct, Milwaukee, WI 53217-1245 | 2006-12-12 |
| 1861563058 | Omprakash Ahuja | Internal Medicine | 3070 N 51st Street, Suite 506, Milwaukee, WI 53210-1645 | 2006-11-11 |
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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.