DR. MICHAEL AMBROSE CRONKLETON (NPI# 1811957590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811957590 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL AMBROSE CRONKLETON |
| Credential | M.D. |
| Practice Address |
1227 E Rusholme St Davenport IA 52803-2459 |
| Mailing Address |
1505 Old Freeport Ct Bettendorf IA 52722-3898 |
| Practice Telephone | 5634211000 |
| Mailing Telephone | 5633552811 |
| Enumeration Date | 2006-03-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
22401 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 1195909-0215 | 05 |
| Street Address |
1227 E RUSHOLME ST |
| City | DAVENPORT |
| State | IA |
| Zip Code | 52803-2459 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083690762 | Ilya B Volfson | Anesthesiology | 1227 E Rusholme St, Davenport, IA 52803-2459 | 2005-12-15 |
| 1912523432 | Abby Mariah Shumate | Nurse Practitioner | 1227 E Rusholme St, Davenport, IA 52803-2459 | 2020-06-20 |
| 1477173532 | Julie Anne Daniels | Occupational Therapist | 1227 E Rusholme St, Davenport, IA 52803-2459 | 2020-04-19 |
| 1083253306 | Charles Grant Dennehey | Physician Assistant | 1227 E Rusholme St, Davenport, IA 52803-2459 | 2020-01-03 |
| 1942850011 | Alyssa Sue Busch | Nurse Practitioner | 1227 E Rusholme St, Davenport, IA 52803-2459 | 2019-09-19 |
| 1528616901 | Genesis Health System | Psychologist | 1227 E Rusholme St, Davenport, IA 52803-2459 | 2019-08-29 |
| 1992260202 | Matthew Adam Steinbeck | Pharmacist | 1227 E Rusholme St, Davenport, IA 52803-2459 | 2019-01-31 |
| 1609394964 | Chelsea Speer | Physician Assistant | 1227 E Rusholme St, Davenport, IA 52803-2459 | 2017-09-06 |
| 1508387382 | Anesthesia Intensive Care LLC | Anesthesiology | 1227 E Rusholme St, Davenport, IA 52803-2459 | 2017-06-30 |
| 1417478314 | Michelle Engstrom | Physical Therapist | 1227 E Rusholme St, Davenport, IA 52803-2459 | 2017-06-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679189971 | Amber Rae Rupiper | Physician Assistant | 518 Locus Street, Davenport, IA 52803 | 2020-09-22 |
| 1558869321 | Devan Louis Depauw | Physician Assistant | 1227 East Rusholme St., Davenport, IA 52803 | 2018-01-26 |
| 1215383070 | Brittney N Hughes | Nurse Practitioner | 1228 E Rusholme Street, Suite 3020, Davenport, IA 52803 | 2016-05-11 |
| 1992138747 | Sarah Beth Schlickman | Nurse Practitioner | 1228 E Rusholme St Ste 3020, Davenport, IA 52803 | 2013-08-15 |
| 1154763845 | Leslie A Poston | Nurse Practitioner | 1228 E. Rushome Street, Mob I, Suite 2100, Davenport, IA 52803 | 2013-07-23 |
| 1083878896 | Jolene Marie Dague | Dentist | 1905 N. Main St, Davenport, IA 52803 | 2008-07-11 |
| 1952436370 | Joann C Milani | Psychologist | 1503 Brady Street, Davenport, IL 52803 | 2007-02-23 |
| 1942343579 | Lisa Clare Ploehn | Pharmacist | 129 West Locust Street, Davenport, IA 52803 | 2007-02-14 |
| 1366597957 | Cathleen Ann Clark | Social Worker | 1706 N Brady, Suite 204, Davenport, IA 52803 | 2007-01-24 |
| 1184781940 | William Burke Ltd | Durable Medical Equipment & Medical Supplies | 129 West Locust, Davenport, IA 52803 | 2007-01-02 |
| Find all providers in zip 52803 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538140405 | Thomas Joseph Kafka | Emergency Medicine | Regional Medical Center, 709 West Main St., Manchester, IA 52057 | 2005-11-08 |
| 1477543668 | Michael M Rosenblatt | Emergency Medicine | 1605 Haskell St, Burlington, IA 52601-1406 | 2005-10-27 |
| 1972098150 | Amanda Sieve | Emergency Medicine | 1200 Pleasant St, Des Moines, IA 50309-1406 | 2018-06-29 |
| 1508374927 | Kari Lynn Tessum | Emergency Medicine | 802 Kenyon Rd, Fort Dodge, IA 50501-5740 | 2018-01-19 |
| 1629312723 | Ottumwa Er LLC | Emergency Medicine | 1001 Pennsylvania Ave, Ottumwa, IA 52501-6427 | 2012-11-15 |
| 1902162191 | Sarah Wolf Field | Emergency Medicine | 500 E Market St, Iowa City, IA 52245 | 2012-04-02 |
| 1235422056 | Brian Michael Kuchay | Emergency Medicine | 621 S Illinois Ave, Mason City, IA 50401-5405 | 2011-05-26 |
| 1497953350 | Heather Noel Stein Poskevich | Emergency Medicine | 1111 6th Ave, Des Moines, IA 50314-2613 | 2007-07-03 |
| 1689705949 | Jackson County Public Hospital | Emergency Medicine | 700 W Grove St, Maquoketa, IA 52060-2163 | 2007-03-08 |
| 1164593109 | Buena Vista Regional Medical Center | Emergency Medicine | 1525 W 5th St, Storm Lake, IA 50588-3027 | 2006-11-13 |
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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.