Cheryl J Iverson, DO
Individual provider Active NPI Family Medicine Physician · Ripon, WI
NPI 1497747885 · NPPES record last updated Oct 24, 2014
Key facts
- NPI
- 1497747885
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 46185-021 (WI)
- Practice address
- 1080 W Fond Du Lac St
Ripon, WI 54971-9286 - Phone
- (920) 748-7000
- Fax
- (920) 748-7236
- NPI assigned
- Aug 22, 2005
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46185-021 | WI | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 46185-021 | WI | Yes |
Addresses
Primary practice location
1080 W Fond Du Lac St
Ripon, WI 54971-9286
Mailing address
1080 W Fond Du Lac St
Ripon, WI 54971-9286
Phone (920) 748-7000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43511200 | Medicaid | WI |
Other providers in Ripon, WI
- Hillside Dental Associates
- Angela Hoffman
- Kathleen Kay Hones
- Robert H House
- Brianne Huettner
- Christopher G Johnson
- Susan Kathryn Kelm
- Thomas B Kloosterboer
- Lakeside Neurocare
- Ashley Lamers
All providers in Ripon, WI · Family Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.