MARK HICHBORN (NPI# 1467410860) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467410860 |
| Entity Type | Individual |
| Full Name | MARK HICHBORN |
| Credential | PA-C |
| Practice Address |
2300 53rd Ave Suite 100 Bettendorf IA 52722-7564 |
| Practice Telephone | 5633220971 |
| Practice Fax Number | 5633240615 |
| Mailing Telephone | 5633220971 |
| Mailing Fax Number | 5633240615 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2011-03-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2300 53RD AVE SUITE 100 |
| City | BETTENDORF |
| State | IA |
| Zip Code | 52722-7564 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932187259 | Peter C Rink | Orthopaedic Surgery | 2300 53rd Ave, Suite 100, Bettendorf, IA 52722-7564 | 2006-01-06 |
| 1699257923 | Lauren Bethany Warner | Nurse Practitioner | 2300 53rd Ave, Bettendorf, IA 52722-7564 | 2018-09-04 |
| 1891171369 | Jessica M Mckearney | Nurse Practitioner | 2300 53rd Ave, Suite 100, Bettendorf, IA 52722-7564 | 2015-08-06 |
| 1609266295 | Rachel Paulsen | Physical Therapist | 2300 53rd Ave, Ll02, Bettendorf, IA 52722-7564 | 2015-02-03 |
| 1679976732 | Stefanie A Glider | Physician Assistant | 2300 53rd Ave, Suite 100, Bettendorf, IA 52722-7564 | 2014-10-03 |
| 1508265398 | Elizabeth Brandt | Occupational Therapist | 2300 53rd Ave, Ste. Ll02, Bettendorf, IA 52722-7564 | 2014-08-18 |
| 1588090476 | Jason Robert Ryckeghem | Physician Assistant | 2300 53rd Ave, Suite 100, Bettendorf, IA 52722-7564 | 2013-09-24 |
| 1609149368 | Kyle A Merten | Physical Therapist | 2300 53rd Ave, Suite Ll02, Bettendorf, IA 52722-7564 | 2012-02-10 |
| 1184904567 | Bradi Michael Peter Kipper | Physician Assistant | 2300 53rd Ave, Suite 100, Bettendorf, IA 52722-7564 | 2011-08-17 |
| 1093022873 | Ryan Travis Pokorney | Orthopaedic Surgery | 2300 53rd Ave, Bettendorf, IA 52722-7564 | 2010-09-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770198855 | Wellspire-bettendorf LLC | Skilled Nursing Facility | 4699 53rd Ave, Bettendorf, IA 52722 | 2020-09-15 |
| 1558873315 | Erin M Kohrt | Speech-Language Pathologist | 2500 Grant Street, Bettendorf, IA 52722 | 2017-11-01 |
| 1437680295 | Holli Christine Martin | Chiropractor | 3048 Victoria St., Bettendorf, IA 52722 | 2017-03-23 |
| 1598219552 | Alyssa Renee Matz | Counselor | 2435 Kimberly Rd Ste 96, Bettendorf, IA 52722 | 2016-08-08 |
| 1144625021 | Athletico Ltd | Physical Therapist | 3252 Ridge Point, Bettendorf, IA 52722 | 2014-11-04 |
| 1609282862 | Katherine L Browne | Nurse Practitioner | 1351 Kimberly Rd Ste 100, Bettendorf, IA 52722 | 2014-07-09 |
| 1316357494 | Kayla Leigh Ehrman | Family Medicine | 2535 Maplecrest Rd Ste 16, Bettendorf, IA 52722 | 2014-04-29 |
| 1043648454 | Duane Anthony Halbur Jr. | Counselor | 2420 Salem Ct, Bettendorf, IA 52722 | 2013-10-22 |
| 1376881185 | Christopher D Murphy | Physical Therapist | 2300 53rd Ave Ll02, Bettendorf, IA 52722 | 2013-01-29 |
| 1326386574 | Kelly C Harry | Occupational Therapist | 3470 Utica Ridge Road, Suite 4, Bettendorf, IA 52722 | 2013-01-23 |
| Find all providers in zip 52722 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295224285 | Misael Garcia | Physician Assistant | 2300 53rd Ave Ste 100, Bettendorf, IA 52722-7565 | 2018-05-04 |
| 1114147915 | Teresa J Palmer | Physician Assistant | 3415 53rd Ave, Bettendorf, IA 52722-6976 | 2007-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932607009 | Margaret Mary Storbakken | Physician Assistant | 200 Hawkins Dr Ste 1562, Iowa City, IA 52242-1009 | 2018-01-24 |
| 1710406590 | Jordan Lee Reiner | Physician Assistant | 12499 University Ave Ste 210, Clive, IA 50325-8288 | 2017-09-13 |
| 1053835256 | Linda Karina Garcia | Physician Assistant | 1410 N Fourth St, Clinton, IA 52732 | 2017-07-29 |
| 1629140041 | Joel E Rand | Physician Assistant | 411 Laurel St Ste 2100, Des Moines, IA 50314-3026 | 2006-11-14 |
| 1073511572 | Stephen Edward Gunn | Physician Assistant | 200 Hawkins Drive, Se 500 Gh, Iowa City, IA 52242 | 2005-07-08 |
| 1609473842 | Hannah Marissa Lester | Physician Assistant | 12499 University Ave Ste 210, Clive, IA 50325-8288 | 2020-10-01 |
| 1154937001 | Christopher Randall | Physician Assistant | 250 S Crescent Dr, Mason City, IA 50401-2926 | 2020-09-16 |
| 1114580495 | Amanda C Mcdonagh | Physician Assistant | 788 8th Ave Se Ste 300, Cedar Rapids, IA 52401-2106 | 2019-04-22 |
| 1184182305 | Ryan E Anderson | Physician Assistant | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2019-03-06 |
| 1760952238 | Kyle J Kroymann | Physician Assistant | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2018-11-27 |
| Find all providers with the same taxonomy | ||||
| City | BETTENDORF |
| Zip Code | 52722 |
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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.