David Carter Redfern, MD

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

30869 Issued in IA

Practice address

1753 W Ridgeway Ave
Ste 106
Waterloo, IA 50701-4588

Phone

(319) 833-5982

Fax

(319) 833-5983

NPI assigned

May 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1750334751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2758",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507042758",
            "telephone_number": "319-833-5982",
            "fax_number": "319-833-5983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1753 W RIDGEWAY AVE",
            "address_2": "STE 106",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507014588",
            "telephone_number": "319-833-5982",
            "fax_number": "319-833-5983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDFERN",
        "first_name": "DAVID",
        "middle_name": "CARTER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "IA",
            "license": "30869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE HEALTH CARE",
            "identifier": "42141730749",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK INS PLAN",
            "identifier": "52489",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0132373",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura K Rasmussen, LISW
• Samuel Rasmussen, LMSW
• Reagan Linae Rathe, PHARMD
• Real Optics Inc (Eyemart Optical in Waterloo)
• Suresh Katapalli Reddy, MD
• Annette Marie Redman, DOCTOR OF AUDIOLOGY
• Shawn E Reese, DDS MS PC
• Prudhvi Regula
• Kristen Kay Reichert, LISW
• Ashley Lyn Reid, D.C.

• Allergy & Immunology Physician in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Allergy & Immunology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; 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.