ACCREDITED DERMATOLOGY ASSOCIATES, P.C. (NPI# 1326176983) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326176983 |
| Entity Type | Organization |
| Organization Name | ACCREDITED DERMATOLOGY ASSOCIATES, P.C. |
| Practice Address |
2322 E Kimberly Rd Suite N100 Davenport IA 52807-7205 |
| Practice Telephone | 5633553376 |
| Mailing Telephone | 5633553376 |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ROBERT F. GODWIN (PRESIDENT) |
| Authorized Official Telephone | 5633553376 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 17538 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0090084 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | ACCREDITED DERMATOLOGY ASSOCIATES, P.C. | 2322 E. Kimberly Road, Davenport, IA 52807 |
| Street Address |
2322 E KIMBERLY RD SUITE N100 |
| City | DAVENPORT |
| State | IA |
| Zip Code | 52807-7205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518931153 | Eugene L Kerns | Obstetrics & Gynecology | 2322 E Kimberly Rd, Davenport, IA 52807-7205 | 2006-02-13 |
| 1043682875 | Maria Terese Menster | Counselor | 2322 E Kimberly Rd, Ste. 200 North, Davenport, IA 52807-7205 | 2015-10-20 |
| 1740651579 | New Life Outpatient Center | Community/Behavioral Health | 2322 E Kimberly Rd, Ste. 200 North, Davenport, IA 52807-7205 | 2015-10-20 |
| 1205251345 | Courtney Hill | Counselor | 2322 E Kimberly Rd, Davenport, IA 52807-7205 | 2014-02-26 |
| 1750706909 | Cheryl Kay Shovlain | Counselor | 2322 E Kimberly Rd, Suite 200 North, Davenport, IA 52807-7205 | 2014-02-25 |
| 1780966804 | New Life Outpatient Center | Community/Behavioral Health | 2322 E Kimberly Rd, Ste. 200 North, Davenport, IA 52807-7205 | 2011-09-14 |
| 1851623367 | Allen L Diercks Dc PC | Chiropractor | 2322 E Kimberly Rd, Davenport, IA 52807-7205 | 2010-02-08 |
| 1699913061 | Nicole Marie Luszczyk | Physician Assistant | 2322 E Kimberly Rd, Ste 100n, Davenport, IA 52807-7205 | 2009-01-23 |
| 1104085497 | Mary Beth Johnson | Nurse Practitioner | 2322 E Kimberly Rd, Davenport, IA 52807-7205 | 2008-06-03 |
| 1871768242 | Weiss Family Chiropractic | Chiropractor | 2322 E Kimberly Rd, Suite 120n, Davenport, IA 52807-7205 | 2008-04-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710455423 | Sarah Duvall | Pharmacist | 2790 East 53rd Street, Davenport, IA 52807 | 2018-11-12 |
| 1932686375 | Costco Wholesale Corporation | Hearing Aid Equipment | 2790 East 53rd St., Davenport, IA 52807 | 2018-07-27 |
| 1902258379 | Secure Dental II, LLC | Dentist | 5025 Utica Ridge Rd, Suite 103, Davenport, IA 52807 | 2016-07-08 |
| 1003288663 | Kristin Landram | Pharmacist | 4011 E 53rd Street, Davenport, IA 52807 | 2015-10-22 |
| 1912384918 | Toshia Johnson | Counselor | 3515 Spring Street, Davenport, IA 52807 | 2015-04-29 |
| 1366849440 | Dennis Aaron Brown | Counselor | 2322 E. Kimberly Rd., Ste. 200 N., Davenport, IA 52807 | 2014-12-04 |
| 1033514914 | Rachel J Staron | Counselor | 2028 E 38th St Ste 3-5, Davenport, IA 52807 | 2014-11-04 |
| 1447651518 | Anthony B. Dexter | Chiropractor | 2178 E Kimberly Rd Ste 400, Davenport, IA 52807 | 2014-09-09 |
| 1932517588 | Alan Christopher Rubach | Dentist | 3435 Spring St Ste 2, Davenport, IA 52807 | 2014-07-28 |
| 1851707459 | Allison Maxwell | Behavioral Analyst | 4959 Utica Ridge Rd, Davenport, IA 52807 | 2014-07-03 |
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| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780081869 | Legends Dermatology, LLC | Dermatology | 1497 Legends Boulevard, Davenport, FL 33896 | 2014-12-04 |
| 1134352677 | Caring Dermatology Center PC | Dermatology | 4624 Progress Dr, Suite D, Davenport, IA 52807-3490 | 2009-09-01 |
| 1609071364 | Jill L. Lightfoot | Dermatology | 2322 E Kimberly Rd Ste 100n, Davenport, IA 52807-7207 | 2007-06-20 |
| 1922047869 | Ravindrakumar Gangadhariah | Dermatology | 4624 Progress Drive Ste D, Davenport, IA 52807 | 2006-06-06 |
| 1144229279 | William Colantoni Jr. | Dermatology | 100 E Kimberly Rd, Suite 303, Davenport, IA 52806-5924 | 2005-07-20 |
| 1790813368 | Robert F. Godwin | Dermatology | 2322 E Kimberly Rd, Suite N100, Davenport, IA 52807-7205 | 2007-03-02 |
| 1396803375 | John Allen Bovenmyer | Dermatology | 3319 Spring St, Suite 102, Davenport, IA 52807-2125 | 2006-12-04 |
| 1477621761 | Bovenmyer Dermatology PC | Dermatology | 3319 Spring St, Suite 102, Davenport, IA 52807-2125 | 2006-12-03 |
| 1942209077 | Wm Colantoni Jr Md PC | Dermatology | 100 E Kimberly Rd, Suite 303, Davenport, IA 52806-5924 | 2005-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730705385 | Iowa Dermatology Consultants, Pllc | Dermatology | 974 73rd St Unit 39&40, West Des Moines, IA 50265-1024 | 2020-06-19 |
| 1558909572 | Iowa Dermatology Clinic Plc | Dermatology | 1895 Se Grimes Blvd., Ste. 103, Grimes, IA 50111-1277 | 2019-12-20 |
| 1134781842 | Iowa Dermatology Clinic Plc | Dermatology | 311 S Clark St Ste 280, Carroll, IA 51401-3086 | 2019-07-02 |
| 1366916371 | Iowa Dermatology Clinic, Plc | Dermatology | 3720 N Ankeny Blvd Ste 101, Ankeny, IA 50023-4605 | 2019-01-14 |
| 1972023414 | Iowa Dermatology Clinic Plc | Dermatology | 9500 University Ave Ste 1114, West Des Moines, IA 50266-1745 | 2017-06-26 |
| 1275998692 | Skinspa LLC | Dermatology | 9350 University Ave Ste 132, West Des Moines, IA 50266-1648 | 2015-12-30 |
| 1083086862 | Iowa Dermatology Clinic, Plc | Dermatology | 3729 86th St, Urbandale, IA 50322 | 2015-10-20 |
| 1639541410 | Iowa Dermatology Clinic, Plc | Dermatology | 1510 Sw Oralabor Rd Ste C, Ankeny, IA 50023-7147 | 2015-10-20 |
| 1760870851 | Forefront Dermatology, S.c. | Dermatology | 202 10th Street, Sw, Suite 290, Cedar Rapids, IA 52403 | 2014-12-26 |
| 1982942702 | Iowa Dermatology Clinic Plc | Dermatology | 26 S 1st Ave, Suite 100, Marshalltown, IA 50158-5032 | 2013-01-29 |
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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.