DR. KEITH ROBERT WOLSTENHOLME (NPI# 1104058502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104058502 |
| Entity Type | Individual |
| Full Name | DR. KEITH ROBERT WOLSTENHOLME |
| Credential | M.D. |
| Practice Address |
200 Hawkins Dr Orthopaedic Surgery Department Iowa City IA 52242-1009 |
| Practice Telephone | 3193537954 |
| Practice Fax Number | 3193849306 |
| Mailing Telephone | 3193537954 |
| Mailing Fax Number | 3193849306 |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2009-08-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
R-8769 | IA | Allopathic & Osteopathic Physicians |
| Street Address |
200 HAWKINS DR ORTHOPAEDIC SURGERY DEPARTMENT |
| City | IOWA CITY |
| State | IA |
| Zip Code | 52242-1009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164425963 | Matthew T Spragg | Emergency Medicine | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2005-05-24 |
| 1205437951 | Jennifer Renee Manternach | Nurse Practitioner | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-11-07 |
| 1144821794 | Jannet S Eastman | Nurse Practitioner | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-11-02 |
| 1043810245 | Abbey Lorraine Foglesong | Dietitian, Registered | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-10-27 |
| 1972101533 | Lindy Pelzer | Nurse Practitioner | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-10-15 |
| 1124626437 | Georgianne Younger | Genetic Counselor, MS | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-10-09 |
| 1114534237 | Bharatendu Chandra | Medical Genetics | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-09-24 |
| 1023625142 | Moon Ley Tung | Medical Genetics | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-09-24 |
| 1225645187 | Sinan Akay | Radiology | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-09-24 |
| 1376158170 | Aygun Asgarli | Psychiatry & Neurology | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-09-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033738679 | Shannon Louise Miers | Physical Therapist | Ui Sports Medicine (iosmr), 2701 Prairie Meadow Drive, Iowa City, IA 52242 | 2020-04-14 |
| 1821624230 | Victoria Troesch | Student in an Organized Health Care Education/Training Program | 375 Newton Rd, Iowa City, IA 52242 | 2020-03-17 |
| 1891338539 | Kira Ann Hennes Blum | Dietitian, Registered | 930 Evashevski Dr., Jacobson Building, Iowa City, IA 52242 | 2019-10-25 |
| 1407330483 | Kristin L Heider | Psychologist | 616 E Bloomington Street, Iowa City, IA 52242 | 2018-09-17 |
| 1447738398 | Allison Kral | Dietitian, Registered | 200 Hawkins Dr. W146 Gh, Iowa City, IA 52242 | 2018-08-02 |
| 1528544780 | Abigail Lynne Schiltz | Physician Assistant | 200 Hawkins Dr 01290a Pfp, Iowa City, IA 52242 | 2018-07-11 |
| 1710474259 | Bashar H. H. Abuqayas | Hospitalist | 200 Hawkins Dr, Se 636 Gh, Uihc-internal Medicine, Iowa City, IA 52242 | 2018-04-19 |
| 1023547395 | Tyler Quist | Internal Medicine | 200 Hawkins Dr Dept of Ophthalmology, Iowa City, IA 52242 | 2017-06-08 |
| 1972962371 | Angeleah Korin Whitlatch | Social Worker | 100 Hawking Drive, Iowa City, IA 52242 | 2016-02-15 |
| 1649667734 | Jennie Sertterh | Specialist/Technologist | 1 Elliot Drive, S181 Carver Hawkeye Arena, Iowa City, IA 52242 | 2015-04-16 |
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| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386048650 | Bastian Uribe-echevarria Marbach | Orthopaedic Surgery | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2014-10-15 |
| 1255326732 | Brian R Wolf | Orthopaedic Surgery | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2005-09-12 |
| 1467445833 | John P Albright | Orthopaedic Surgery | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2005-08-31 |
| 1043202419 | Annunziato Amendola | Orthopaedic Surgery | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2005-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356392062 | James D Wolff Md PC | Orthopaedic Surgery | 2700 1st Ave S, Suite 100, Fort Dodge, IA 50501-4306 | 2006-05-15 |
| 1790749448 | William C Jacobson | Orthopaedic Surgery | 12499 University Ave, Suite 210, Des Moines, IA 50325-8281 | 2006-04-12 |
| 1245745074 | Grand View University | Orthopaedic Surgery | 1200 Grandview Ave, Des Moines, IA 50316-1529 | 2017-12-01 |
| 1376908897 | The Finley Hospital | Orthopaedic Surgery | 350 N Grandview Ave, Dubuque, IA 52001-6388 | 2015-12-29 |
| 1033485404 | Ruslan Safarov | Orthopaedic Surgery | 2730 Pierce St Ste 300, Sioux City, IA 51104 | 2012-03-29 |
| 1902190879 | Kristyn Marie Darmafall | Orthopaedic Surgery | 3385 Dexter Ct Ste 300, Davenport, IA 52807-3471 | 2011-06-08 |
| 1326378720 | Iowa Orthopaedic Center, P.C. | Orthopaedic Surgery | 450 Laurel St, Ste A, Des Moines, IA 50314-3045 | 2010-01-06 |
| 1902134406 | Tri-state Specialists, LLP | Orthopaedic Surgery | 2730 Pierce St Ste 300, Sioux City, IA 51104-3765 | 2009-11-23 |
| 1134358500 | Kellen L Huston | Orthopaedic Surgery | 1 Edmundson Pl, Suite 500, Council Bluffs, IA 51503-4658 | 2009-07-07 |
| 1922219047 | William C. Jacobson Md PC | Orthopaedic Surgery | 1601 Nw 114th St, Suite 142, Des Moines, IA 50325-7007 | 2007-05-24 |
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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.