Jennifer Lickteig, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

34237 Issued in IA

Practice address

788 8TH Ave SE
Cedar Rapids, IA 52401-2119

Phone

(319) 362-1551

NPI assigned

Mar 23, 2006

Sex

Female

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Eastern Iowa Health Center

  • Community/Retail Pharmacy
  • Cedar Rapids, IA
  • NPI 1346048675
  NPD (past)
• Eastern Iowa Health Center

  • Family Medicine Physician
  • Cedar Rapids, IA
  • NPI 1578753703
  NPD (past)
• Eastern Iowa Sleep Center, LLC

  • Sleep Disorder Diagnostic Clinic/Center
  • Cedar Rapids, IA
  • NPI 1851598767
  NPD (past)
• Mercy Medical Center

  • Psychiatry Physician
  • Cedar Rapids, IA
  • NPI 1700834165
  NPD (past)
• Respiratory and Critical Care Associates

  • Pulmonary Disease Physician
  • Cedar Rapids, IA
  • NPI 1477739985
  NPD (past)

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1801856091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1824",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524061824",
            "telephone_number": "319-369-4505",
            "fax_number": "319-369-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "788 8TH AVE SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524012119",
            "telephone_number": "319-362-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICKTEIG",
        "first_name": "JENNIFER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "34237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4213900",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Molly Catherine Leytze, OTR/L
• Wei Li, M.D.
• Weiwei Li, M.B.
• Xiaofeng Li, DDS
• Chad Michael Libby, A.T.C.
• Life Connection, L.C.
• Victoria A Life
• Lifeline Trust Care LLC
• Lifepoint Dental Partners V
• Nicholas Lind, MD

• Family Medicine Physician in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.