DR. RICHARD T KETTELKAMP (NPI# 1922042894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922042894 |
| Entity Type | Individual |
| Full Name | DR. RICHARD T KETTELKAMP |
| Credential | DO |
| Practice Address |
202 10th St Se Suite 225 Cedar Rapids IA 52403-2404 |
| Practice Telephone | 3193647101 |
| Mailing Telephone | 3193647101 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2018-11-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
3618 | IA | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
3618 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 1922042894 | 05 | |
| IA | RR MEDICARE | P00823157 | 01 |
| Street Address |
202 10TH ST SE SUITE 225 |
| City | CEDAR RAPIDS |
| State | IA |
| Zip Code | 52403-2404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326045600 | Hugh Philip Macmenamin | Orthopaedic Surgery | 202 10th St Se, Cedar Rapids, IA 52403-2404 | 2005-07-01 |
| 1598304065 | Justin Kreiter | Physical Therapist | 202 10th St Se, Cedar Rapids, IA 52403-2414 | 2020-01-02 |
| 1346889813 | Elizabeth Brown | Physical Therapist | 202 10th St Se, Cedar Rapids, IA 52403-2414 | 2020-01-02 |
| 1922666585 | Courtney M Lansing | Audiologist | 202 10th St Se, Cedar Rapids, IA 52403-2414 | 2019-05-30 |
| 1740745538 | Annette Keller Qualben | Registered Nurse | 202 10th St Se, Cedar Rapids, IA 52403-2414 | 2019-02-05 |
| 1790256048 | Jenny Lynn Botsford | Nurse Practitioner | 202 10th St Se, Cedar Rapids, IA 52403-2414 | 2018-12-16 |
| 1790288397 | Amber Arthurs | Nurse Practitioner | 202 10th St Se, Cedar Rapids, IA 52403-2414 | 2018-03-10 |
| 1033645189 | Mina Soleimani | Family Medicine | 202 10th St Se, Cedar Rapids, IA 52403-2414 | 2017-05-11 |
| 1962934877 | Pruchno Medicine LLC. / Health Transitions Clinic | Dietary Manager | 202 10th St Se, Cedar Rapids, IA 52403-2414 | 2017-03-30 |
| 1871034686 | Brandey Cordes | Audiologist | 202 10th St Se, Suite 200, Cedar Rapids, IA 52403-2414 | 2017-03-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093242083 | Eric Burton | Social Worker | 1535 1st Ave Se., Cedar Rapids Va Cboc, Cedar Rapids, IA 52403 | 2017-05-22 |
| 1619404613 | Dylan Roberts Streb | Family Medicine | Eastern Iowa Health Center, 1201 Third Avenue Se, Cedar Rapids, IA 52403 | 2017-05-22 |
| 1760870851 | Forefront Dermatology, S.c. | Dermatology | 202 10th Street, Sw, Suite 290, Cedar Rapids, IA 52403 | 2014-12-26 |
| 1801292883 | Laura Pelechek | Marriage & Family Therapist | 1744 2nd Ave Se, Cedar Rapids, IA 52403 | 2014-11-18 |
| 1306090147 | John Daniel Schuchmann | Anesthesiology | 3629 Random Road Se, Cedar Rapids, IA 52403 | 2008-11-06 |
| 1851564157 | Cedar Rapids Medical Education Foundation | Family Medicine | 1260 Second Avenue S.e., Cedar Rapids, IA 52403 | 2008-04-08 |
| 1093866071 | Mcld Corporation | Durable Medical Equipment & Medical Supplies | 207 2nd Avenue Se Ste A, Cedar Rapids, IA 52403 | 2007-01-16 |
| 1154483980 | James P Schuller | Dentist | 1000 42nd St Se, 1000 Professional Centre Suite B, Cedar Rapids, IA 52403 | 2006-12-15 |
| 1477640183 | C R Iv Service Inc | Home Health | 402 10th St, Ste 700 Carepro Home Health, Cedar Rapids, IA 52403 | 2006-10-06 |
| 1104919638 | C R Iv Service Inc | Durable Medical Equipment & Medical Supplies | 402 10th Street Se, Suite 700, Cedar Rapids, IA 52403 | 2006-10-02 |
| Find all providers in zip 52403 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1083693949 | Eric J Dippel | Internal Medicine | 3385 Dexter Ct Ste 100, Davenport, IA 52807-3471 | 2006-01-10 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | CEDAR RAPIDS |
| Zip Code | 52403 |
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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.