CIACCIO MEDICAL, P.C. (NPI# 1043481179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043481179 |
| Entity Type | Organization |
| Organization Name | CIACCIO MEDICAL, P.C. |
| Practice Address |
1401 W Central Park Ave Davenport IA 52804-1707 |
| Mailing Address |
1441 W Central Park Ave Davenport IA 52804-1707 |
| Practice Telephone | 3092368075 |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2008-03-17 |
| Authorized Official Name | DR. JOHN CLEO CIACCIO (PRESIDENT) |
| Authorized Official Telephone | 3092368075 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
Allopathic & Osteopathic Physicians | ||
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| Street Address |
1401 W CENTRAL PARK AVE |
| City | DAVENPORT |
| State | IA |
| Zip Code | 52804-1707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699762369 | Thomas J Stoffel | Radiology | 1401 W Central Park Ave, Davenport, IA 52804-1707 | 2005-09-28 |
| 1699309377 | Marie Mueller | Nurse Practitioner | 1401 W Central Park Ave, Davenport, IA 52804-1707 | 2020-03-02 |
| 1144850801 | Alexandria Nicole Lyon | Psychologist | 1401 W Central Park Ave, Davenport, IA 52804-1707 | 2020-01-22 |
| 1497272538 | Rebekka Jacobs | Social Worker | 1401 W Central Park Ave, Davenport, IA 52804-1707 | 2017-08-29 |
| 1245665405 | Stephen C Rasmus Md PC | Psychiatry & Neurology | 1401 W Central Park Ave, Davenport, IA 52804-1707 | 2013-09-06 |
| 1710276183 | Genesis Health System | Psychiatric Unit | 1401 W Central Park Ave, Davenport, IA 52804-1707 | 2011-04-06 |
| 1568604916 | Kiwhoon Lee | Radiology | 1401 W Central Park Ave, Davenport, IA 52804-1707 | 2009-04-01 |
| 1588694012 | Rickey L. Wilson | Psychiatry & Neurology | 1401 W Central Park Ave, Davenport, IA 52804-1707 | 2006-07-03 |
| 1649233909 | Janis Diane Smith | Psychologist | 1401 W Central Park Ave, Davenport, IA 52804-1707 | 2006-04-08 |
| 1598745267 | Fareeduddin Ahmed | Physical Medicine & Rehabilitation | 1401 W Central Park Ave, Davenport, IA 52804-1707 | 2006-01-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265948467 | Tess Nelson | Physical Medicine & Rehabilitation | 2535 Maplecrest Rd Suite 23, Bettendorf, IA 52804 | 2017-12-26 |
| 1124494380 | Erica Lauren Hempel Bucy | Social Worker | 1333 W. Lombard St. Ste C, Davenport, IA 52804 | 2015-08-11 |
| 1477859890 | Kristin L West | Registered Nurse | 1441 W. Centrral Park Ave, Vera French Community Mental Health Center, Davenport, IA 52804 | 2011-02-02 |
| 1679877625 | Linda Marie Crownover-inch | Doula | 1420 W 16th Street, #412, Davenport, IA 52804 | 2011-01-05 |
| 1124169032 | Lawrence R Huber | Dentist | 2305 Jersey Ridge Rd, Davenport, IA 52804 | 2007-02-12 |
| 1669532388 | Providence Therapy Services LLC | Physical Therapist | 21037 Holden Drive, Davenport, IA 52804 | 2006-12-11 |
| 1639183171 | Megan Denise Long | Occupational Therapist | 31037 Holden Dr, Davenport, IA 52804 | 2006-07-28 |
| 1811919772 | Theresa L Schlabach | Occupational Therapist | 21037 Holden Dr, Davenport, IA 52804 | 2006-07-23 |
| 1225097843 | William M Nissen | Psychiatry & Neurology | 1441 W Central Park, Davenport, IA 52804 | 2006-03-22 |
| 1245721851 | Mackenzie J Banwart | Physical Therapist | 1700 N Division St Ste 200, Davenport, IA 52804 | 2018-05-21 |
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| 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 |
|---|---|---|---|---|
| 1962958264 | Qualicare Psychiatry L.L.C. | Psychiatry & Neurology | 42725 Us-27, Suite # 202, Davenport, FL 33837 | 2016-08-28 |
| 1942613955 | Center for Behavioral Health Iowa, Inc. | Psychiatry & Neurology | 3811 N Harrison St, Davenport, IA 52806-5911 | 2014-06-06 |
| 1912163866 | Fady Ashamalla | Psychiatry & Neurology | 42725 Highway 27, Ste 202, Davenport, FL 33837-6821 | 2008-07-31 |
| 1174576169 | Joseph Michael Bertroche | Psychiatry & Neurology | 4622 Progress Dr, Suite A, Davenport, IA 52807-3426 | 2006-05-18 |
| 1225097843 | William M Nissen | Psychiatry & Neurology | 1441 W Central Park, Davenport, IA 52804 | 2006-03-22 |
| 1679568133 | Vidyasagar Reddy Vangala | Psychiatry & Neurology | 2504 Sand Mine Rd, Davenport, FL 33897-3402 | 2005-09-12 |
| 1912991340 | Ghada Hamdan-allen | Psychiatry & Neurology | 1441 W Central Park Ave, Davenport, IA 52804-1707 | 2005-08-31 |
| 1407274293 | Mi Nelson | Psychiatry & Neurology | 4622 Progress Dr, Davenport, IA 52807-3426 | 2014-03-31 |
| 1336450790 | Henry Frank Emerle | Psychiatry & Neurology | 1441 W Central Park Ave, Davenport, IA 52804-1707 | 2010-06-30 |
| 1649307331 | Alice J. Harpring | Psychiatry & Neurology | 1441 W Central Park Ave, Davenport, IA 52804-1707 | 2007-02-28 |
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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.