DR. GEORGE WILLIAM DITTRICK (NPI# 1669530630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669530630 |
| Entity Type | Individual |
| Full Name | DR. GEORGE WILLIAM DITTRICK |
| Credential | M.D. |
| Practice Address |
8111 Dodge St Ste. 263 Omaha NE 68114-4129 |
| Mailing Address |
Po Box 3755 Omaha NE 68103-0755 |
| Practice Telephone | 4023548163 |
| Practice Fax Number | 4023542416 |
| Mailing Telephone | 4023542100 |
| Mailing Fax Number | 4023542155 |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2016-05-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | ME103180 | FL | Allopathic & Osteopathic Physicians |
| Y | 2086X0206X |
Surgery Specialization: Surgical Oncology |
25264 | NE | Allopathic & Osteopathic Physicians |
| N | 2086X0206X |
Surgery Specialization: Surgical Oncology |
ME103180 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 1669530630 | 05 | |
| NE | 10025868900 | 05 | |
| NE | 47068731707 | 05 |
| Street Address |
8111 DODGE ST STE. 263 |
| City | OMAHA |
| State | NE |
| Zip Code | 68114-4129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831191196 | Raymond M Crossman | Ophthalmology | 8111 Dodge St, Ste 143, Omaha, NE 68114-4100 | 2005-06-01 |
| 1720385131 | Elizabeth A Jacobsen | Physician Assistant | 8111 Dodge St, Suite 363, Omaha, NE 68114-4129 | 2011-02-21 |
| 1811294515 | Stacey Anne Shinaut | Nurse Practitioner | 8111 Dodge St, Suite 363, Omaha, NE 68114-4129 | 2011-02-16 |
| 1831324813 | Omaha Travel Clinic, P.C. | Internal Medicine | 8111 Dodge St, Suite 363, Omaha, NE 68114-4129 | 2009-05-20 |
| 1346497757 | Courtney D Sullivan | Nurse Practitioner | 8111 Dodge St, Suite 363, Omaha, NE 68114-4129 | 2008-08-27 |
| 1659558781 | Rebecca C Mckenzie | Nurse Practitioner | 8111 Dodge St, Suite 363, Omaha, NE 68114-4129 | 2008-01-31 |
| 1285816785 | Cindy L Sedlak | Physician Assistant | 8111 Dodge St, Ste. 220, Omaha, NE 68114-4129 | 2007-11-27 |
| 1376754408 | Paul Kolkman | Surgery | 8111 Dodge St, Suite 263, Omaha, NE 68114-4129 | 2007-05-24 |
| 1295847382 | Brad A Winterstein | Surgery | 8111 Dodge St, Suite 263, Omaha, NE 68114-4129 | 2006-08-31 |
| 1508976978 | Christina Prauner | Nurse Practitioner | 8111 Dodge St, Suite 332, Omaha, NE 68114-4129 | 2006-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689237356 | Jared Nathan Holthaus | Optometrist | 625 N. 98th St, Omaha, NE 68114 | 2019-04-18 |
| 1346701869 | On Site Health and Wellness, LLC | Dietitian, Registered | 7905 Pacific Street, Omaha, NE 68114 | 2019-03-27 |
| 1801301205 | Logan Johnson | Specialist/Technologist | 8803 Webster Plz, Omaha, NE 68114 | 2017-12-06 |
| 1992224687 | Douglas Medical Supplies | Durable Medical Equipment & Medical Supplies | 7914 W Dodge Rd Ste 916, Omaha, NE 68114 | 2017-09-13 |
| 1023568540 | Active Spine Physical Therapy, LLC | Clinic/Center | 10110 Nicholas St Ste 100, Omaha, NE 68114 | 2016-10-07 |
| 1417400706 | Kayla Ann Leddy | Counselor | 7701 Pacific St Ste 100a, Omaha, NE 68114 | 2016-08-03 |
| 1134561103 | Julio Cesar Deleon Iv | Counselor | 9212 California Plaza #308, Omaha, NE 68114 | 2013-07-19 |
| 1477992261 | Nicole Janine Lecci | Dentist | 8910 Indian Hills Drive, Suite 200, Omaha, NE 68114 | 2013-06-14 |
| 1538504436 | Christian Louis Barney | Radiology | 8303 Dodge St Ste Ll6, Omaha, NE 68114 | 2013-05-06 |
| 1558606665 | Nbd Solutions | Durable Medical Equipment & Medical Supplies | 327 N 78 Street, Omaha, NE 68114 | 2012-11-29 |
| Find all providers in zip 68114 | ||||
| Taxonomy Code | 2086X0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgical Oncology |
| A surgical oncologist is a well-qualified surgeon who has obtained additional training and experience in the multidisciplinary approach to the prevention, diagnosis, treatment, and rehabilitation of cancer patients, and devotes a major portion of his or her professional practice to these activities and cancer research. |
| Notes: Source: Society of Surgical Oncology, 2007 [1/1/2008: definition added, source added, 7/1/2009: definiition reformatted] Additional Resources: http://www.surgonc.org/ ; American Board of Medical Specialties, 2007, www.abms.org ; American Board of Surgery, 2007, http://www.absurgery.org/ Surgical oncology is a recognized fellowship subspecialty program of surgery. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023246220 | Bradley Norman Reames | Surgery | 505 S 48th St, Omaha, NE 68198-0001 | 2009-06-25 |
| 1659489466 | Jason M. Foster | Surgery | 601 N 30th St Ste 2803, Omaha, NE 68131-2137 | 2006-08-29 |
| 1417404633 | Jessica E Maxwell | Surgery | 983280 Nebraska Medical Ctr, Omaha, NE 68198-3280 | 2016-09-06 |
| 1275977654 | Jessica Barbara Shank | Surgery | 505 S. 45th St, Omaha, NE 68198-0001 | 2013-04-29 |
| 1144467291 | Nicole De Rosa | Surgery | Emile 42nd St, Omaha, NE 68198-0001 | 2009-01-12 |
| 1801987839 | Brian W Loggie | Surgery | 601 N 30th St Ste 2803, Omaha, NE 68131-2137 | 2006-09-27 |
| 1942315569 | Edibaldo Silva Lopez | Surgery | Emile 42nd St, Omaha, NE 68198-2315 | 2006-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891924809 | Kinzie Adele Norris | Surgery | 301 N 27th St, Suite 11, Norfolk, NE 68701-4401 | 2009-07-11 |
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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.