JENNIFER LICKTEIG (NPI# 1801856091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801856091 |
| Entity Type | Individual |
| Full Name | JENNIFER LICKTEIG |
| Credential | MD |
| Practice Address |
788 8th Ave Se Cedar Rapids IA 52401-2119 |
| Mailing Address |
Po Box 1824 Cedar Rapids IA 52406-1824 |
| Practice Telephone | 3193621551 |
| Mailing Telephone | 3193694505 |
| Mailing Fax Number | 3193694677 |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2007-10-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 34237 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 4213900 | 05 |
| Street Address |
788 8TH AVE SE |
| City | CEDAR RAPIDS |
| State | IA |
| Zip Code | 52401-2119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669476602 | Brandon Elliott Bourgeous | Obstetrics & Gynecology | 788 8th Ave Se, Suite 100, Cedar Rapids, IA 52401-2107 | 2005-06-08 |
| 1306210729 | Michelle Ann Donohue | Nurse Practitioner | 788 8th Ave Se, Suite 400, Cedar Rapids, IA 52401-2107 | 2015-11-23 |
| 1619383486 | Samuel Drahos | Nurse Practitioner | 788 8th Ave Se, Level 4 / Suite 400, Cedar Rapids, IA 52401-2107 | 2014-07-01 |
| 1518211192 | Anne K Nugent | Nurse Practitioner | 788 8th Ave Se, Ste 400, Cedar Rapids, IA 52401-2107 | 2012-11-03 |
| 1265784326 | Mercy Physician Associates, Inc | Family Medicine | 788 8th Ave Se, Ste 200, Cedar Rapids, IA 52401-2107 | 2012-10-12 |
| 1508147018 | Mercy Physician Associates, Inc | Family Medicine | 788 8th Ave Se, Suite 204, Cedar Rapids, IA 52401-2107 | 2011-08-30 |
| 1982921128 | Amandeep Singh Dhaliwal | Internal Medicine | 788 8th Ave Se, Suite 400, Cedar Rapids, IA 52401-2107 | 2010-04-28 |
| 1689878175 | Ryan Hollenbeck | Internal Medicine | 788 8th Ave Se, Cedar Rapids, IA 52401-2107 | 2007-06-11 |
| 1952510034 | Eduardo Arturo Celis Valdiviezo | Internal Medicine | 788 8th Ave Se, Suite 200, Cedar Rapids, IA 52401-2107 | 2007-05-22 |
| 1538378591 | Nora A Royer | Surgery | 788 8th Ave Se, Suite 300, Cedar Rapids, IA 52401-2107 | 2007-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326688516 | Sejal Patel | Marriage & Family Therapist | 819 5th Street, Cedar Rapids, IA 52401 | 2020-01-15 |
| 1992135693 | Mark Valliere | Internal Medicine | 947 14th Ave. Se, Community Health Free Clinic, Cedar Rapids, IA 52401 | 2013-11-15 |
| 1184988453 | Hassan Sajjad | Internal Medicine | 788 8th Ave Se Ste 200, Cedar Rapids, IA 52401 | 2012-07-01 |
| 1760755714 | Kashif Nadeem Chaudhry | Internal Medicine | 788 8th Avenue Se; Suite 400, Cedar Rapids, IA 52401 | 2012-02-21 |
| 1639332745 | Bhavya Akhauri | Internal Medicine | 788 8th Avenue Se, Level 3, Cedar Rapids, IA 52401 | 2008-07-08 |
| 1972663748 | Samuel B Thompson | Social Worker | 210 2nd St Suite 200, Cedar Rapids, IA 52401 | 2006-12-11 |
| 1477635811 | Melinda Schwarz Yehyawi | Physician Assistant | 947 14th Ave Se, Community Health Free Clinic, Cedar Rapids, IA 52401 | 2006-10-19 |
| 1154377463 | Anwar Ahmed | Internal Medicine | 543 7th Street Se, Cedar Rapids, IA 52401 | 2006-05-26 |
| 1780663005 | Mary Jo Henry | Nurse Practitioner | 115 8th St Ne, Cedar Rapids, IA 52401 | 2006-01-13 |
| 1437522869 | Kellie Colleen Alexander | Social Worker | 819 5th St Se, Cedar Rapids, IA 52401 | 2015-11-06 |
| Find all providers in zip 52401 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619404613 | Dylan Roberts Streb | Family Medicine | Eastern Iowa Health Center, 1201 Third Avenue Se, Cedar Rapids, IA 52403 | 2017-05-22 |
| 1619422748 | Mercy Physician Associates, Inc | Family Medicine | 777 76th Ave Dr Sw, Cedar Rapids, IA 52404 | 2016-08-18 |
| 1295967677 | Katherine Joanne Alatorre | Family Medicine | 4325 Williams Blvd Sw, Cedar Rapids, IA 52404-3436 | 2009-08-18 |
| 1649438383 | Qadnana Atif Anwar | Family Medicine | 4325 Williamsa Blvd, Cedar Rapids, IA 52404 | 2008-05-29 |
| 1851564157 | Cedar Rapids Medical Education Foundation | Family Medicine | 1260 Second Avenue S.e., Cedar Rapids, IA 52403 | 2008-04-08 |
| 1326260399 | Robert Lynn Swaney | Family Medicine | 947 14th St Se, Cedar Rapids, IA 52401-2610 | 2007-05-02 |
| 1467504506 | Jami A Maxson | Family Medicine | 2815 Edgewood Road S.w., Cedar Rapids, IA 52404 | 2007-01-17 |
| 1649359035 | Nancy M Angenend | Family Medicine | 500 8th Ave Se, Cedar Rapids, IA 52401-2134 | 2006-11-04 |
| 1104912765 | Marian L Barnes | Family Medicine | 3835 Cottage Grove Avenue Se, Cedar Rapids, IA 52403-2124 | 2006-10-04 |
| 1699880138 | Affiliates of Family Practice of Cedar Rapids | Family Medicine | 1030 5th Avenue Se, Suite 1700, Cedar Rapids, IA 52403 | 2006-08-21 |
| Find all providers in CEDAR RAPIDS | ||||
| City | CEDAR RAPIDS |
| Zip Code | 52401 |
Please comment or provide details below to improve the information on JENNIFER LICKTEIG.
| 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.