DAVID J DEDRICK (NPI# 1154360931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154360931 |
| Entity Type | Individual |
| Full Name | DAVID J DEDRICK |
| Credential | M.D. |
| Practice Address |
1506 S Oneida St Appleton WI 54915-1305 |
| Mailing Address |
200 E Washington St P O Box 8031 Appleton WI 54911-5490 |
| Practice Telephone | 9207382000 |
| Mailing Telephone | 8002368252 |
| Mailing Fax Number | 9207390124 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
38508-20 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32496700 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831177385 | David L Dedrick | Specialist | 2042 Ne Williamson Ct, St. Charles Sleep Center - Bend, Bend, OR 97701-3760 | 2006-01-05 |
| Street Address |
1506 S ONEIDA ST |
| City | APPLETON |
| State | WI |
| Zip Code | 54915-1305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205828654 | Gladys Beth Michaelson | Registered Nurse | 1506 S Oneida St, Appleton, WI 54915-1305 | 2005-08-19 |
| 1184249773 | Allison Nierode | Student in an Organized Health Care Education/Training Program | 1506 S Oneida St, Appleton, WI 54915-1305 | 2020-06-10 |
| 1700401429 | Amanda Sue Mansfield | Occupational Therapy Assistant | 1506 S Oneida St, Appleton, WI 54915-1305 | 2020-06-09 |
| 1063044782 | Rebecca Ann Kloehn | Nurse Practitioner | 1506 S Oneida St, Appleton, WI 54915-1305 | 2020-02-11 |
| 1124658422 | Jeremy Scott Wells | Registered Nurse | 1506 S Oneida St, Appleton, WI 54915-1305 | 2020-01-25 |
| 1477104388 | Hitomi Gunsolley | Psychologist | 1506 S Oneida St, Appleton, WI 54915-1305 | 2019-09-23 |
| 1861045957 | Brianna M Montano | Counselor | 1506 S Oneida St, Appleton, WI 54915-1305 | 2019-07-18 |
| 1902458177 | Kelsey Gregory | Nurse Practitioner | 1506 S Oneida St, Appleton, WI 54915-1305 | 2019-07-09 |
| 1700442100 | Maija K West | Occupational Therapist | 1506 S Oneida St, Appleton, WI 54915-1305 | 2019-05-13 |
| 1750947263 | Samuel Markert | Nurse Practitioner | 1506 S Oneida St, Appleton, WI 54915-1305 | 2019-05-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205466737 | Leyes Robers Dental LLC | Dentist | 3216 W County Rd Kk, Appleton, WI 54915 | 2020-01-23 |
| 1912426958 | Shanna L. Larsen | Registered Nurse | 1101 E. South River St., Appleton, WI 54915 | 2017-09-11 |
| 1477082816 | Amy Fazel | Driver | 226 E Calumet St, Appleton, WI 54915 | 2017-06-08 |
| 1871940213 | B.a.israel LLC | Community Based Residential Treatment Facility, Mental Illness | N9520 Silver Court, Appleton, WI 54915 | 2016-05-16 |
| 1982933479 | Stephanie I. Braski | Counselor | 1531 S. Oneida St, Appleton, WI 54915 | 2009-12-14 |
| 1386808319 | Shawn S Williamson | Emergency Medicine | 1506 South Oneida Street, Appleton, WI 54915 | 2008-07-18 |
| 1700040870 | Heidi Jo Van Toll | Occupational Therapist | 1335 S Oneida Street, Appleton, WI 54915 | 2008-07-17 |
| 1669639142 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | N9642 County Rd N, Appleton, WI 54915 | 2008-05-21 |
| 1265699748 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1531 S Madison St Fl 4, Appleton, WI 54915 | 2008-05-21 |
| 1073770558 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1531 S Madison St Ste 580, Appleton, WI 54915 | 2008-05-21 |
| Find all providers in zip 54915 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093754988 | Peter V Podlusky | Pathology | 1506 S Oneida St, Appleton, WI 54915-1305 | 2006-06-06 |
| 1649219130 | Thomas C Rayson | Pathology | 1506 S Oneida St, Appleton, WI 54915-1305 | 2006-06-06 |
| 1205886918 | Butte Des Morts Pathology, S.c. | Pathology | 1506 S Oneida St, Appleton, WI 54915-1305 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992316533 | Andrii Puzyrenko | Pathology | 9200 W Wisconsin Ave Ste L83, Milwaukee, WI 53226-3522 | 2020-08-16 |
| 1487040127 | Michelle Stoffel | Pathology | Uw Hospital and Clinics, 600 Highland Ave, Madison, WI 53792 | 2015-04-09 |
| 1447694328 | Patrick Stephen Rush | Pathology | 600 Highland Ave. H4/831, Uw Hospital and Clinics, Madison, WI 53792 | 2013-04-23 |
| 1346501756 | James Murray Angevine | Pathology | 602 Mineral Pt Road, Apt 214, Madison, WI 53705-4577 | 2012-06-01 |
| 1023314549 | Stephen Lee Mcclellan | Pathology | N4656 Lakeshore Dr, Kewaunee, WI 54216-9794 | 2011-01-31 |
| 1922231414 | Darrell Peter Skarphol | Pathology | 2480 Edgewood Ct, Green Bay, WI 54302-4813 | 2009-08-31 |
| 1518110147 | Werner Adam Reis | Pathology | 839 N Jefferson St Ste 300, Milwaukee, WI 53202-3744 | 2008-10-28 |
| 1598927444 | Leela C Thachenkary | Pathology | 7107-49th Ave, Kenosha, WI 53142 | 2008-07-01 |
| 1326211384 | Scott James Kantola | Pathology | 2800 Westhill Dr Ste 208, Wausau, WI 54401-3770 | 2008-04-10 |
| 1437355997 | Monica Goswami | Pathology | 10472 W Montana Ave, # 215, West Allis, WI 53227-3263 | 2007-06-22 |
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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.