TRINITY MEDICAL CENTER (NPI# 1033163829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033163829 |
| Entity Type | Organization |
| Organization Name | TRINITY MEDICAL CENTER |
| Practice Address |
2701 17th St Rock Island IL 61201-5351 |
| Mailing Address |
4600 3rd St Moline IL 61265-6106 |
| Practice Telephone | 3097793000 |
| Mailing Telephone | 3097792032 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2017-04-11 |
| Authorized Official Name | MR. JOSEPH PROVATEARE (DIRECTOR SUPPORT SERVICES) |
| Authorized Official Telephone | 3097792022 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 273R00000X | Psychiatric Unit | Hospital Units | ||
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCWELLMARK ENRICH GR | 04049 | 01 | |
| IL | RR MEDICARE | CB8530 | 01 |
| IA | 0219253 | 05 | |
| BCWELLMARK GROUP | 99817 | 01 | |
| IL | RR MEDICARE | CB8516 | 01 |
| IA | 0276170 | 05 | |
| IL | RR MEDICARE | CK0834 | 01 |
| IL | RR MEDICARE | CB8166 | 01 |
| IL | RR MEDICARE | CB8524 | 01 |
| BCILLINOIS RYC | 8115303 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285684423 | Trinity Medical Center | Ambulance | 4469 48th Avenue Ct, Rock Island, IL 61201-9213 | 2006-05-10 |
| 1528225760 | Trinity Medical Center | Rehabilitation, Substance Use Disorder Unit | 4600 3rd St, Moline, IL 61265-6106 | 2008-05-16 |
| 1912022302 | Trinity Medical Center | Ambulance | 4500 Utica Ridge Rd, Bettendorf, IA 52722-1626 | 2007-03-21 |
| 1427173822 | Trinity Medical Center | Ambulance | 4469 48th Avenue Ct, Rock Island, IL 61201-9213 | 2007-03-21 |
| 1124110820 | Trinity Medical Center | General Acute Care Hospital | 4500 Utica Ridge Rd, Bettendorf, IA 52722-1626 | 2006-09-29 |
| 1336231992 | Trinity Medical Center | Skilled Nursing Facility | 2701 17th St, Rock Island, IL 61201-5351 | 2006-09-29 |
| 1245322809 | Trinity Medical Center | Rehabilitation Unit | 2701 17th St, Rock Island, IL 61201-5351 | 2006-09-29 |
| 1316047632 | Trinity Medical Center | Psychiatry & Neurology | 2701 17th St, Rock Island, IL 61201-5351 | 2006-09-25 |
| 1770699902 | Trinity Medical Center | General Practice | 555 Valley View Dr, Moline, IL 61265-6138 | 2006-08-21 |
| 1184644783 | Trinity Medical Center | Physician Assistant | 2351 W Locust St, Davenport, IA 52804-3329 | 2006-07-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | TRINITY MEDICAL CENTER | 2701 17th St, Rock Island, IL 61201-5351 |
| Iowa Business Entities | TRINITY MEDICAL CENTER | 270117th St, Rock Island, IL 61201 |
| System for Award Management (SAM) Entities | TRINITY MEDICAL CENTER EAST | 380 Summit Ave, Steubenville, OH 43952-2667 |
| Street Address |
2701 17TH ST |
| City | ROCK ISLAND |
| State | IL |
| Zip Code | 61201-5351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336142629 | Deepak Ahuja | Internal Medicine | 2701 17th St, Rock Island, IL 61201-5351 | 2005-05-31 |
| 1205436052 | Penny Ann Liebbe | Psychiatry & Neurology | 2701 17th St, Rock Island, IL 61201-5351 | 2020-10-30 |
| 1740880863 | Ginger I Busby | Counselor | 2701 17th St, Rock Island, IL 61201-5351 | 2020-10-28 |
| 1366041022 | Elizabeth Erin Montgomery | Registered Nurse | 2701 17th St, Rock Island, IL 61201-5351 | 2020-10-22 |
| 1285232587 | Jillian Elizabeth Spragg | Counselor | 2701 17th St, Rock Island, IL 61201-5393 | 2020-10-09 |
| 1902403140 | Kelsey Jean Mickelson | Counselor | 2701 17th St, Rock Island, IL 61201-5351 | 2020-10-01 |
| 1033725452 | Amber Michelle Winters | Counselor | 2701 17th St, Rock Island, IL 61201-5351 | 2020-09-21 |
| 1295341865 | Kaitlyn Dawn Shannon | Counselor | 2701 17th St, Rock Island, IL 61201-5351 | 2020-09-19 |
| 1902412539 | Alex Strupp | Counselor | 2701 17th St, Rock Island, IL 61201-5351 | 2020-09-18 |
| 1861008641 | Leanne Elizabeth Zazzetti | Counselor | 2701 17th St, Rock Island, IL 61201-5351 | 2020-09-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689206245 | Judy Kay Moore | Technician | 2439 8th Ave, Rock Island, IL 61201 | 2020-02-11 |
| 1053956862 | Christina Beam | Counselor | 1413 40th Street, Rock Island, IL 61201 | 2019-11-15 |
| 1356843817 | Stephanie Kaye Jones | Counselor | 2701 17th St., Rock Island, IL 61201 | 2018-03-01 |
| 1073062030 | Innovative Transport Enterprise, LLC | Non-emergency Medical Transport (VAN) | 2239 24th Street Apt 15c, Rock Island, IL 61201 | 2016-09-30 |
| 1124575733 | Robert Young Center | Community Based Residential Treatment Facility, Mental Illness | 2701 - 17 Street, Rockisland, IL 61201 | 2016-09-01 |
| 1538520903 | James Keith Frainey | Psychologist | 805 19th Street, Transitions Mhs, Rock Island, IL 61201 | 2016-03-14 |
| 1417340837 | Brandon Lee Sachwitz | Physician Assistant | 2701 17th Street, Trinity Medical Center, Rock Island, IL 61201 | 2015-03-10 |
| 1215366679 | Kimberly Lyall | Physical Therapy Assistant | 767 30th Street, Rock Island, IL 61201 | 2013-11-06 |
| 1386080745 | The Abbey Center, LLC | Clinic/Center | 3031 5th Ave., Rock Island, IL 61201 | 2013-05-13 |
| 1487097382 | Joe Lee Westerhof | Veterinarian | 2529 11th St, Rock Island, IL 61201 | 2013-04-10 |
| Find all providers in zip 61201 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376575795 | Eduardo A Ricaurte | Psychiatry & Neurology | 2560 24th Street, Suite 101, Rock Island, IL 61201-5389 | 2006-07-07 |
| 1205436052 | Penny Ann Liebbe | Psychiatry & Neurology | 2701 17th St, Rock Island, IL 61201-5351 | 2020-10-30 |
| 1891180154 | Dara Ann Wilczynski | Psychiatry & Neurology | 2701 17th St, Rock Island, IL 61201 | 2015-04-03 |
| 1316047632 | Trinity Medical Center | Psychiatry & Neurology | 2701 17th St, Rock Island, IL 61201-5351 | 2006-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346840659 | Amelia Mari Merz | Psychiatry & Neurology | 1101 Lake St Ste 201b, Oak Park, IL 60301-1046 | 2020-10-27 |
| 1063024925 | Mindful Psychiatric Care LLC | Psychiatry & Neurology | 120 E Ogden Ave Ste 101, Hinsdale, IL 60521-3892 | 2020-08-20 |
| 1053921296 | Healing Hands Resource Center | Psychiatry & Neurology | 6607 W Main St, Belleville, IL 62223-3025 | 2020-08-03 |
| 1144848086 | Zachary A Kordik Md PC | Psychiatry & Neurology | 25 E Washington St Ste 904, Chicago, IL 60602-1715 | 2020-07-07 |
| 1629694278 | Montes Psychiatric Center, P.C. | Psychiatry & Neurology | 717 Trent Ln, Loves Park, IL 61111-8956 | 2020-06-19 |
| 1659996767 | Bluesky Telepsych | Psychiatry & Neurology | 4753 N Broadway St Ste 910, Chicago, IL 60640-4991 | 2020-06-15 |
| 1164047833 | Advanced Psychiatry Clinics, S.c. | Psychiatry & Neurology | 5519 N Cumberland Ave Ste 1016, Chicago, IL 60656-1480 | 2020-06-09 |
| 1326661802 | Psychmed Clinic Inc | Psychiatry & Neurology | 2159 W Madison St, Chicago, IL 60612-2307 | 2020-05-19 |
| 1467074534 | Holmes Psychiatry LLC | Psychiatry & Neurology | 2027 W Division St # 144, Chicago, IL 60622-9024 | 2020-05-12 |
| 1902434947 | Saadiya Jabbar | Psychiatry & Neurology | Loyola University Medical Center, Building 105, Suite 1940, Maywood, IL 60153 | 2020-03-27 |
| Find all providers with the same taxonomy | ||||
| City | ROCK ISLAND |
| Zip Code | 61201 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.