WILLIAM J PROVANCE (NPI# 1174517403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174517403 |
| Entity Type | Individual |
| Full Name | WILLIAM J PROVANCE |
| Credential | DO |
| Practice Address |
681 Goodlette Rd N Ste 130 Naples FL 34102-5458 |
| Mailing Address |
3434 Hancock Bridge Pkwy Ste 301 North Fort Myers FL 33903-7094 |
| Practice Telephone | 2396439767 |
| Practice Fax Number | 2396495878 |
| Mailing Telephone | 8778563774 |
| Mailing Fax Number | 2395992625 |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2014-09-04 |
| NPI Deactivation Date | 03/24/2006 |
| NPI Reactivation Date | 2007-08-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
OS12406 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 0013977160006 | 05 | |
| PA | PALMETTOGBA | P00252222 | 01 |
| Street Address |
681 GOODLETTE RD N STE 130 |
| City | NAPLES |
| State | FL |
| Zip Code | 34102-5458 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366434599 | Todd R Burmeister | Podiatrist | 681 Goodlette Rd N, #160, Naples, FL 34102-5458 | 2005-08-15 |
| 1881125649 | Foot and Ankle Mgmt | Podiatrist | 681 Goodlette Rd N, Suite 160, Naples, FL 34102-5458 | 2017-03-23 |
| 1215478987 | Herbert Gates IIi Md Pa | Orthopaedic Surgery | 681 Goodlette Rd N, Suite 220, Naples, FL 34102-5458 | 2017-03-15 |
| 1023494580 | Brian Connell | Social Worker | 681 Goodlette Rd N, Suite 150, Naples, FL 34102-5458 | 2015-08-07 |
| 1356694723 | Associates In Gastroenterology LLC | Internal Medicine | 681 Goodlette Rd N, Ste 130, Naples, FL 34102-5458 | 2012-10-22 |
| 1356648489 | Leslie Karp Roth | Speech-Language Pathologist | 681 Goodlette Rd N, Ste 150, Naples, FL 34102-5458 | 2011-02-25 |
| 1639479264 | Susan Nolan | Physician Assistant | 681 Goodlette Rd N, Suite 130, Naples, FL 34102-5458 | 2010-10-29 |
| 1851521348 | Kathleen Susanne Gates | Nurse Practitioner | 681 Goodlette Rd N, Suite 220, Naples, FL 34102-5458 | 2009-07-20 |
| 1295987030 | Keith P Hussey Md Pa | Internal Medicine | 681 Goodlette Rd N, Suite 130, Naples, FL 34102-5458 | 2008-10-10 |
| 1700035979 | Linda B Nelson | Speech-Language Pathologist | 681 Goodlette Rd N, Suite 150, Naples, FL 34102-5458 | 2008-09-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710482948 | Aktive Motion Physical Therapy Inc | Clinic/Center | 1250 9th St N Ste 204, Naples, FL 34102 | 2018-03-28 |
| 1912428632 | Daily Care At Home, LLC | Home Health | 180 9th Street South, Suite 200, Naples, FL 34102 | 2017-07-03 |
| 1760737365 | Family Private Care Inc | Home Health | 1008 Goodlette Frank Rd N, Ste 201, Naples, FL 34102 | 2012-07-19 |
| 1013205384 | Valerie Jean Bress | Nurse Practitioner | 350 7th Street, Naples Community Hospital, Naples, FL 34102 | 2011-07-20 |
| 1154573830 | Gustavo D Rivera | Internal Medicine | 1064 Goodlette Road, Naples, FL 34102 | 2008-10-14 |
| 1881872281 | Proscan Imaging Naples, LLC | Radiology | 260 Tamiami Trail N, Naples, FL 34102 | 2008-02-07 |
| 1053595017 | Marlene Ann Diaczynsky | Registered Nurse | 350 7th Street North, Naples Community Hospital, Naples, FL 34102 | 2007-12-26 |
| 1699958330 | Georgiena Cobb | Counselor | 501 Goodlette Rd, Naples, FL 34102 | 2007-12-17 |
| 1124210158 | Maranatha Home Care, Inc. | Registered Nurse | 1164 Goodlette Road, Naples, FL 34102 | 2007-08-14 |
| 1669678645 | Naples Family Dentistry Inc | Dentist | 2176 Tamiami Trail North, Naples, FL 34102 | 2007-06-26 |
| Find all providers in zip 34102 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| 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 |
|---|---|---|---|---|
| 1033668165 | Manuel Bustamante M.d. P.a. | Internal Medicine | 3369 Pine Ridge Rd, Suite 203, Naples, FL 34109-3932 | 2016-09-30 |
| 1962802926 | Guy Winzenried Md LLC | Internal Medicine | 5077 Tamiami Trl E, Naples, FL 34113-4128 | 2014-08-27 |
| 1831524339 | Julian Sison | Internal Medicine | 681 Goodlette Rd N Ste 130, Naples, FL 34102-5612 | 2013-09-04 |
| 1023380516 | Rosann Schwartz, M.d., P.a. | Internal Medicine | 700 2nd Ave N., #304, Naples, FL 34102-5702 | 2012-01-31 |
| 1457414732 | Charles J Buysse Jr. | Internal Medicine | 400 Eighth St N, Naples, FL 34102 | 2006-12-18 |
| 1659381614 | Advanced Gastroenterology of Naples, LLC | Internal Medicine | 4760 Tamiami Trl N, Ste 27, Naples, FL 34103-3025 | 2006-08-09 |
| 1811906779 | Shardul Ashwin Nanavati | Internal Medicine | 4760 Tamiami Trail North, Suite 27, Naples, FL 34103-3884 | 2006-08-07 |
| 1356694723 | Associates In Gastroenterology LLC | Internal Medicine | 681 Goodlette Rd N, Ste 130, Naples, FL 34102-5458 | 2012-10-22 |
| 1760753636 | Maged Mokhtar Bakr | Internal Medicine | 311 9th St N, Ste 304, Naples, FL 34102-5885 | 2012-01-24 |
| 1235448184 | Scott L Wiesen Md LLC | Internal Medicine | 625 Tamiami Trl N, Suite 304, Naples, FL 34102-8143 | 2010-09-27 |
| Find all providers in NAPLES | ||||
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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.