Dr Roy Lidtke PLC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

00555 Issued in IA

Legal business name

DR ROY LIDTKE PLC

Practice address

1026 A Ave NE
Suite 5000
Cedar Rapids, IA 52402-5036

Phone

(319) 929-5572

NPI assigned

Sep 15, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Roy Lidtke, MD

Title

Medical Director

Phone

(319) 929-5572

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1252972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252972800000",
    "number": "1881927341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 284",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503010280",
            "telephone_number": "516-883-7100",
            "fax_number": "516-883-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 A AVE NE",
            "address_2": "SUITE 5000",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524025036",
            "telephone_number": "319-929-5572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR ROY LIDTKE PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-15",
        "last_updated": "2009-09-15",
        "status": "A",
        "authorized_official_last_name": "LIDTKE",
        "authorized_official_first_name": "ROY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "319-929-5572",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "IA",
            "license": "00555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Podiatrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2009; 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.