Wayne Michael Sliwa, EDD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

00402 Issued in IA

Practice address

2102 E 38TH St
Davenport, IA 52807

Phone

(563) 359-4049

Fax

(563) 359-4069

NPI assigned

Jul 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365724800000",
    "number": "1215957618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2102 E 38TH ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "52807",
            "telephone_number": "563-359-4049",
            "fax_number": "563-359-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 E 38TH ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "52807",
            "telephone_number": "563-359-4049",
            "fax_number": "563-359-4069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLIWA",
        "first_name": "WAYNE",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "EDD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2013-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IA",
            "license": "00402",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071-002353",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012096",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Davenport, IA
• Providers in Davenport, IA by specialty
• Psychologist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.