ALLIANCE HEALTH & DERMATOLOGY (NPI# 1790818599) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790818599 |
| Entity Type | Organization |
| Organization Name | ALLIANCE HEALTH & DERMATOLOGY |
| Other Organization Name | C/O RAMIRO ICAZA |
| Practice Address |
304 S Mount Auburn Rd Cape Girardeau MO 63703-4920 |
| Practice Telephone | 5738033331 |
| Practice Fax Number | 5738032905 |
| Mailing Telephone | 5738033331 |
| Mailing Fax Number | 5732433400 |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2020-02-06 |
| Authorized Official Name | MR. RAMIRO ICAZA (ADMINISTRATOR) |
| Authorized Official Telephone | 5732432154 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MDR7D79 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 593695703 | 05 |
| Other Name | Type Code |
|---|---|
| c/o Ramiro Icaza | Other Name - Individual/Organization |
| Street Address |
304 S MOUNT AUBURN RD |
| City | CAPE GIRARDEAU |
| State | MO |
| Zip Code | 63703-4920 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811999691 | Kakeung Charles Cheung | Specialist | 304 S Mount Auburn Rd, Cape Girardeau, MO 63703-4920 | 2005-08-11 |
| 1952958449 | Alliance Health and Dermatology, LLC | Dermatology | 304 S Mount Auburn Rd, Cape Girardeau, MO 63703-4920 | 2019-08-20 |
| 1851633242 | Lawrence Feigenbaum | Dermatology | 304 S Mount Auburn Rd, Cape Girardeau, MO 63703-4920 | 2013-03-23 |
| 1437404761 | Josh D. Gast | Internal Medicine | 304 S Mount Auburn Rd, Cape Girardeau, MO 63703-4920 | 2012-07-24 |
| 1457606618 | Jason Douglas | Physician Assistant | 304 S Mount Auburn Rd, Cape Girardeau, MO 63703-4920 | 2012-07-13 |
| 1093085458 | Mary Elizabeth Jarrells | Nurse Practitioner | 304 S Mount Auburn Rd, Cape Girardeau, MO 63703-4920 | 2012-01-03 |
| 1285942813 | Ashley Camp | Surgery | 304 S Mount Auburn Rd, Cape Girardeau, MO 63703 | 2010-09-16 |
| 1194046482 | Dsmedical, LLC | Durable Medical Equipment & Medical Supplies | 304 S Mount Auburn Rd, Cape Girardeau, MO 63703-4920 | 2010-06-21 |
| 1083934731 | Pam J Hiett | Registered Nurse | 304 S Mount Auburn Rd, Cape Girardeau, MO 63703-4920 | 2010-06-04 |
| 1871782649 | Donald Shane Bailey | Specialist/Technologist, Other | 304 S Mount Auburn Rd, Cape Girardeau, MO 63703-4920 | 2007-10-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720566102 | Christian Torres Diaz | Dentist | 3070 William Street, Cape Girardeau, MO 63703 | 2018-07-30 |
| 1457758153 | Broadway Ltc, LLC | Pharmacy | 37 Doctors Park Ste 7, Cape Girardeau, MO 63703 | 2014-11-24 |
| 1336562263 | Rachel Speer | Community Health Worker | 20 South Sprigg St, Cape Girardeau, MO 63703 | 2014-01-29 |
| 1245653120 | Mary Wilburn | Community Health Worker | 20 S Spigg, Cape Girardeau, MO 63703 | 2014-01-28 |
| 1831523695 | Saint Francis Medical Center | General Acute Care Hospital | 150 South Mount Auburn Road, Suite 342, Cape Girardeau, MO 63703 | 2013-08-29 |
| 1033481163 | J K Essmyer Medical Services LLC | Clinic/Center | 300 Mt Auburn Rd, Auburn Surgery Center, Inc, Cape Girardeau, MO 63703 | 2012-02-06 |
| 1477867844 | Drx - East Missouri Providers, P.C. | Family Medicine | 465 S Mount Auburn Road, Suite 103, Cape Girardeau, MO 63703 | 2010-07-28 |
| 1346564879 | Richard William Tobey | Family Medicine | 3250 Gordonville Rd Ste 301, Cape Girardeau, MO 63703 | 2010-03-26 |
| 1144413568 | Stephanie Danette Miller | Family Medicine | 817 S. Mount Auburn, Suite 100, Southeast Primary Care, Cape Gerardeau, MO 63703 | 2007-08-20 |
| 1437349305 | Shanaree Mae Muzinich | Radiology | 70 Doctor's Park, Cape Girardeau, MO 63703 | 2007-07-27 |
| Find all providers in zip 63703 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013542828 | Johns Healthcare Services LLC | Family Medicine | 2001 Independence St Ste A, Cape Girardeau, MO 63703-5805 | 2020-03-12 |
| 1326503376 | Ebo Md LLC | Family Medicine | 1417 N Mount Auburn Rd Ste A, Cape Girardeau, MO 63701-2171 | 2019-02-04 |
| 1780943753 | Jessica Leanne Cox | Family Medicine | 817 S Mount Auburn Rd # 100, Cape Girardeau, MO 63703-6383 | 2012-05-11 |
| 1306133129 | Andrew J Lawrence | Family Medicine | 1723 Broadway St Ste 315, Cape Girardeau, MO 63701-4556 | 2011-06-30 |
| 1477867844 | Drx - East Missouri Providers, P.C. | Family Medicine | 465 S Mount Auburn Road, Suite 103, Cape Girardeau, MO 63703 | 2010-07-28 |
| 1346564879 | Richard William Tobey | Family Medicine | 3250 Gordonville Rd Ste 301, Cape Girardeau, MO 63703 | 2010-03-26 |
| 1679766406 | Byron Cornelius Glenn | Family Medicine | 1353 N Mount Auburn Rd, Suite B, Cape Girardeau, MO 63701-1723 | 2007-08-24 |
| 1356473797 | Kenneth A Decoursey | Family Medicine | 1723 Broadway, Suite 120, Cape Girardeau, MO 63701 | 2007-03-12 |
| 1225171804 | Charity Beth Sandvos | Family Medicine | 817 S Mount Auburn Rd Ste 100, Cape Girardeau, MO 63703-6383 | 2007-02-14 |
| 1497765994 | Charles J. Lastrapes, D.o., LLC | Family Medicine | 937 Broadway St, Suite 203, Cape Girardeau, MO 63701-5493 | 2006-08-08 |
| Find all providers in CAPE GIRARDEAU | ||||
| City | CAPE GIRARDEAU |
| Zip Code | 63703 |
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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.