John R Liddicoat, M.D.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

209670 Issued in MA

Practice address

7601 Northland Dr N
Minneapolis, MN 55428-4500

Phone

(763) 360-7961

NPI assigned

Oct 4, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cardiothoracic Surgical Associates

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Greensburg, PA
  • NPI 1164404653
  NPD (past)
• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  dba HMFP - Surgery

  • Surgery Physician
  • Boston, MA
  • NPI 1720037385

  Thoracic Surgery (Cardiothoracic Vascular Surgery)

  NPD (past)

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191456000000",
    "number": "1750579694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2208 OLIVER AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554052441",
            "telephone_number": "763-360-7961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 NORTHLAND DR N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554284500",
            "telephone_number": "763-360-7961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIDDICOAT",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-04",
        "last_updated": "2007-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MA",
            "license": "209670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracey Lichner, PHD
• Micaela Lichtenstein
• Hannah Shacter Lichtsinn, M.D.
• Gina Liddell-Westefeld
• Emily Liddicoat, LICSW
• Nancy Liddy
• Julie E Liebelt, PT
• Travis Liebhard, PHARMD
• Barbara E Liebo
• Rhoda Volk Liebo, MD

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.