ELIZABETH DAWN WIETFELDT (NPI# 1962623827) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962623827 |
| Entity Type | Individual |
| Full Name | ELIZABETH DAWN WIETFELDT |
| Credential | M.D. |
| Practice Address |
900 N 1st St Springfield IL 62702-3749 |
| Mailing Address |
1025 S 6th St Springfield IL 62703-2403 |
| Practice Telephone | 2175287541 |
| Mailing Telephone | 2175287541 |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-05-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208C00000X | Colon & Rectal Surgery | 036129667 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
900 N 1ST ST |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-3749 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114920139 | Mary Beth Ditman | Nurse Practitioner | 900 N 1st St, Springfield, IL 62702-3749 | 2005-05-23 |
| 1013536804 | Amy N Mann | Nurse Practitioner | 900 N 1st St, Springfield, IL 62702-3749 | 2020-04-11 |
| 1295217727 | Michelle Lee Mccoy | Registered Nurse | 900 N 1st St, Springfield, IL 62702-3749 | 2018-08-31 |
| 1538640941 | Samantha E. Dunkirk | Nurse Practitioner | 900 N 1st St, Springfield, IL 62702-3749 | 2018-08-23 |
| 1376037168 | Stephanie M. Ritter | Registered Nurse | 900 N 1st St, Springfield, IL 62702-3749 | 2018-06-15 |
| 1396237376 | Jennifer L. Johnson | Registered Nurse | 900 N 1st St, Springfield, IL 62702-3749 | 2018-06-05 |
| 1265800163 | Josiah Hamilton | Physician Assistant | 900 N 1st St, Springfield, IL 62702-3749 | 2015-09-09 |
| 1700268216 | Lyndsey Heise | Internal Medicine | 900 N 1st St, Springfield, IL 62702-3749 | 2015-06-19 |
| 1689081861 | Todd Diebold | Obstetrics & Gynecology | 900 N 1st St, Springfield, IL 62702-3749 | 2014-07-19 |
| 1629418454 | Kara Lynn Mccoy | Obstetrics & Gynecology | 900 N 1st St, Springfield, IL 62702-3749 | 2013-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 208C00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Colon & Rectal Surgery |
| A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Colon and Rectal Surgery, 2007. http://www.abcrs.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Colon and Rectal Surgery. Colon and rectal surgeons have the expertise to diagnose and often manage anorectal conditions such as hemorrhoids, fissures (painful tears in the anal lining), abscesses and fistulae (infections located around the anus and rectum) in the office setting. They also treat problems of the intestine and colon, and perform endoscopic procedures to evaluate and treat problems such as cancer, polyps (precancerous growths) and inflammatory conditions. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164405585 | Jan B Wojcik | Colon & Rectal Surgery | 175 Carew Street, Suite 110, Springfield, MA 01104 | 2005-11-21 |
| 1457348401 | Jan Rakinic | Colon & Rectal Surgery | 315 W Carpenter St, 2nd Floor, Springfield, IL 62702-4901 | 2005-10-04 |
| 1902149644 | Jennifer Lu | Colon & Rectal Surgery | 1965 S Fremont Ave Ste 100, Springfield, MO 65804 | 2013-04-01 |
| 1164759924 | Rakesh Hegde | Colon & Rectal Surgery | 1001 E Primrose St, Springfield, MO 65807 | 2009-11-14 |
| 1760608764 | Drs Green and Hodge Inc | Colon & Rectal Surgery | 1176 E Home Rd, Springfield, OH 45503 | 2007-04-18 |
| 1164554044 | John Trombold | Colon & Rectal Surgery | 1001 E Primrose St, Springfield, MO 65807-5155 | 2007-03-09 |
| 1558458349 | John D. Zander | Colon & Rectal Surgery | 900 N. 1st Street, Springfield, IL 62702-3749 | 2006-10-05 |
| 1659465813 | James W. Thiele | Colon & Rectal Surgery | 900 N. 1st Street, Springfield, IL 62702-3749 | 2006-10-03 |
| 1043317373 | Peter M.c. Hofmann | Colon & Rectal Surgery | 900 N 1st St, Springfield, IL 62702-3749 | 2006-09-20 |
| 1023088978 | Imran Hassan | Colon & Rectal Surgery | 315 W Carpenter St, 2 Nd Floor, Springfield, IL 62702-4901 | 2006-01-24 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
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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.