William Burke LTD

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

774 Issued in IA

Legal business name

WILLIAM BURKE LTD

Practice address

129 West Locust
Davenport, IA 52803

Phone

(563) 324-1641

Fax

(563) 324-3005

NPI assigned

Jan 2, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Andrew Ploehn

Title

Owner

Phone

(563) 324-5004

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• MAIN AT LOCUST PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• William Burke LTD

  • Clinic Pharmacy
  • Davenport, IA
  • NPI 1851620066

  5395644843

  Same PAC ID

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 8

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Colonial Manors of Columbus Community Inc

  • Skilled Nursing Facility
  • Columbus Junction, IA
  • NPI 1982779724

  Adp of the SNF

  CMS ownership
• Iowa Mennonite Benevolent Association

  • Skilled Nursing Facility
  • Kalona, IA
  • NPI 1497741557

  Adp of the SNF

  CMS ownership
• Lutheran Home for the Aged Association-East

  • Skilled Nursing Facility
  • Davenport, IA
  • NPI 1730259813

  Adp of the SNF

  CMS ownership
• Simpson Memorial Home Inc

  • Skilled Nursing Facility
  • West Liberty, IA
  • NPI 1033106620

  Adp of the SNF

  CMS ownership
• Simpson Memorial Home Inc

  • Skilled Nursing Facility
  • Wilton, IA
  • NPI 1033544655

  Adp of the SNF, Indirect Ownership Interest

  CMS ownership
• Solon Nursing Care Center Inc

  • Skilled Nursing Facility
  • Solon, IA
  • NPI 1083798086

  Adp of the SNF

  CMS ownership
• Wayland Mennonite Home Association

  • Skilled Nursing Facility
  • Wayland, IA
  • NPI 1215940556

  Adp of the SNF

  CMS ownership
• Wheatland Manor Inc

  • Skilled Nursing Facility
  • Wheatland, IA
  • NPI 1811956485

  Adp of the SNF

  CMS ownership

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708646400000",
    "number": "1184781940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151 KIMBERLY RD",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527223628",
            "telephone_number": "563-324-5004",
            "fax_number": "563-324-3305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 WEST LOCUST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "52803",
            "telephone_number": "563-324-1641",
            "fax_number": "563-324-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM BURKE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A",
        "authorized_official_last_name": "PLOEHN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "563-324-5004"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IA",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "IA",
            "license": "16D0922143",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "59654",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0069195",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0233577",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAIN AT LOCUST PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kari Elizabeth Wiese, OT
• Lindsay K Wiese, RD. LD
• Rebecca Andresen Wiese, MD
• Matthew Theodore Wieskamp
• Angela R Willi, LISW
• William Burke LTD
• William Burke LTD
• William Burke LTD
• William H Bausch DDS PC
• Anthony Jon Williams, DDS

• Community/Retail Pharmacy in Davenport, IA
• Providers in Davenport, IA by specialty
• Community/Retail Pharmacy in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.