Trevor Dismore (NPI# 1891144119, PAC ID# 5991043614) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CLINICAL SOCIAL WORKER.
| Nation Provider ID (NPI) | 1891144119 |
| PAC ID by PECOS | 5991043614 |
| Professional Enrollment ID | I20190205001137 |
| Full Name | Trevor Dismore |
| Organization Legal Name | NORTHEAST IOWA MENTAL HEALTH CENTER |
| Address |
36 S Frederick Oelwein IA 50662-2305 |
| Phone Number | 5632835774 |
| Gender | M |
| Graduation Year | 2016 |
| Primary Specialty | CLINICAL SOCIAL WORKER |
| Group Practice PAC ID | 1355230475 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 905 Montgomery St, Decorah, IA 52101-2325 | 5633823649 | NORTHEAST IOWA MENTAL HEALTH CENTER |
| 36 S Frederick, Oelwein, IA 50662-2305 | 5632835774 | NORTHEAST IOWA MENTAL HEALTH CENTER |
| 3251 W 9th St, Waterloo, IA 50702-5310 | 3192342893 | BLACK HAWK-GRUNDY MENTAL HEALTH CENTER INC |
| Organization Legal Name | NORTHEAST IOWA MENTAL HEALTH CENTER |
| Physicians | 10 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William Bernard Deutsch | Clinical Social Worker | Northeast Iowa Mental Health Center | 905 Montgomery St, Decorah, IA 52101-2325 |
| Vithalji J Modha | Psychiatry | Northeast Iowa Mental Health Center | 36 S Frederick, Oelwein, IA 50662-2305 |
| Chitchawal Sahatevasukont | Nurse Practitioner | Northeast Iowa Mental Health Center | 36 S Frederick, Oelwein, IA 50662-2305 |
| Stephanie Grusy Garcia-prats | Clinical Social Worker | Northeast Iowa Mental Health Center | 36 S Frederick, Oelwein, IA 50662-2305 |
| Karla J Wolfs | Clinical Social Worker | Northeast Iowa Mental Health Center | 36 S Frederick, Oelwein, IA 50662-2305 |
| Kathryn Elizabeth Sieck | Clinical Social Worker | Northeast Iowa Mental Health Center | 36 S Frederick, Oelwein, IA 50662-2305 |
| Jerri L Harlen | Nurse Practitioner | Northeast Iowa Mental Health Center | 36 S Frederick, Oelwein, IA 50662-2305 |
| Diana Jean Mount | Clinical Social Worker | Northeast Iowa Mental Health Center | 36 S Frederick, Oelwein, IA 50662-2305 |
| Bhasker J Dave | Psychiatry | Northeast Iowa Mental Health Center | 36 S Frederick, Oelwein, IA 50662-2305 |
| Street Address |
36 S FREDERICK |
| City | OELWEIN |
| State | IA |
| Zip | 50662-2305 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Vithalji J Modha | Psychiatry | Northeast Iowa Mental Health Center | 36 S Frederick, Oelwein, IA 50662-2305 |
| Chitchawal Sahatevasukont | Nurse Practitioner | Northeast Iowa Mental Health Center | 36 S Frederick, Oelwein, IA 50662-2305 |
| Stephanie Grusy Garcia-prats | Clinical Social Worker | Northeast Iowa Mental Health Center | 36 S Frederick, Oelwein, IA 50662-2305 |
| Karla J Wolfs | Clinical Social Worker | Northeast Iowa Mental Health Center | 36 S Frederick, Oelwein, IA 50662-2305 |
| Kathryn Elizabeth Sieck | Clinical Social Worker | Northeast Iowa Mental Health Center | 36 S Frederick, Oelwein, IA 50662-2305 |
| Jerri L Harlen | Nurse Practitioner | Northeast Iowa Mental Health Center | 36 S Frederick, Oelwein, IA 50662-2305 |
| Diana Jean Mount | Clinical Social Worker | Northeast Iowa Mental Health Center | 36 S Frederick, Oelwein, IA 50662-2305 |
| Bhasker J Dave | Psychiatry | Northeast Iowa Mental Health Center | 36 S Frederick, Oelwein, IA 50662-2305 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Timothy D Gearhart | Chiropractic | Gearhart Chiropractic PC | 14 8th Ave Ne, Oelwein Chiropractic Clinic, Oelwein, IA 50662-1938 |
| Brianne C Byerly | Occupational Therapy | Performance Rehab LLC | 204 E Charles St, Performance Rehab, Oelwein, IA 50662-1940 |
| Taylor L Coyle | Physical Therapy | Performance Rehab LLC | 204 E Charles St, Performance Rehab, Oelwein, IA 50662-1940 |
| Rachel A Kleitsch | Physical Therapy | Performance Rehab LLC | 204 E Charles St, Performance Rehab, Oelwein, IA 50662-1940 |
| Kyla Danielle Peak | Physical Therapy | Performance Rehab LLC | 204 E Charles St, Performance Rehab, Oelwein, IA 50662-1940 |
| Todd Anthony Bradley | Physical Therapy | Performance Rehab LLC | 204 E Charles St, Performance Rehab, Oelwein, IA 50662-1940 |
| Sara Katherine Hennessy | Occupational Therapy | Performance Rehab LLC | 204 E Charles St, Performance Rehab, Oelwein, IA 50662-1940 |
| Bradley J Brown | Chiropractic | 901 E Charles St, Oelwein, IA 50662-1951 | |
| Sara A Berns | Physician Assistant | Iowa Physicians Clinic Medical Foundation | 124 1st Ave Se, Family Medicine Oelwein, Oelwein, IA 50662-2321 |
| Trisha Ann Kress | Nurse Practitioner | Iowa Physicians Clinic Medical Foundation | 124 1st Ave Se, Family Medicine Oelwein, Oelwein, IA 50662-2321 |
| Find all physicians in zip 50662 | |||
| City | OELWEIN |
| Zip Code | 50662 |
| Specialty | CLINICAL SOCIAL WORKER |
| City + Specialty | OELWEIN + CLINICAL SOCIAL WORKER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.