PSYCHIATRIC ASSOCIATES OF NORTHEAST IOWA PC (NPI# 1457428112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457428112 |
| Entity Type | Organization |
| Organization Name | PSYCHIATRIC ASSOCIATES OF NORTHEAST IOWA PC |
| Practice Address |
146 W Dale St Ste 101 Waterloo IA 50703-1901 |
| Practice Telephone | 3192333351 |
| Practice Fax Number | 3192353132 |
| Mailing Telephone | 3192333351 |
| Mailing Fax Number | 3192353132 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. RAJA MUHAMMAD AKBAR (PRESIDENT) |
| Authorized Official Telephone | 3192333351 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103TC1900X |
Psychologist Specialization: Counseling |
Behavioral Health & Social Service Providers | ||
| X | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| X | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | BLUE CROSS BLUE SHIELD | 53382 | 01 |
| IA | 1144634 | 05 |
| Street Address |
146 W DALE ST STE 101 |
| City | WATERLOO |
| State | IA |
| Zip Code | 50703-1901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366428559 | Hridendra N Basu | Internal Medicine | 146 W Dale St, Suite 201, Waterloo, IA 50703-1901 | 2005-12-20 |
| 1083077465 | Karlea J Norby | Advanced Practice Midwife | 146 W Dale St, Suite 102, Waterloo, IA 50703-1901 | 2016-04-01 |
| 1588047021 | Kimberlee Kay Borneman | Advanced Practice Midwife | 146 W Dale St, Suite 102, Waterloo, IA 50703-1901 | 2015-07-01 |
| 1801211693 | Jessica Frana | Nurse Practitioner | 146 W Dale St, Suite 201, Waterloo, IA 50703-1901 | 2014-03-03 |
| 1578828406 | Breanna C. Herring | Advanced Practice Midwife | 146 W Dale St, Suite 102, Waterloo, IA 50703-1901 | 2012-07-06 |
| 1700149366 | Ahmad A Alwassia | Internal Medicine | 146 W Dale St, Suite 203, Waterloo, IA 50703-1901 | 2012-06-19 |
| 1093076671 | Vara Venkata Padma Kamala Kumari Ponnada | Family Medicine | 146 W Dale St, Suite 201, Waterloo, IA 50703-1901 | 2012-05-31 |
| 1154637692 | Joellen Cizek Kubik | Nurse Practitioner | 146 W Dale St, Suite 101, Waterloo, IA 50703-1901 | 2010-08-22 |
| 1295058113 | Angela Mae Woods | Social Worker | 146 W Dale St, Ste 101, Waterloo, IA 50703-1901 | 2010-03-05 |
| 1942455746 | Jayachandra Babu Vavilathota | Student in an Organized Health Care Education/Training Program | 146 W Dale St, Suite 201, Waterloo, IA 50703-1901 | 2008-11-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306363841 | Kristie Wood | Counselor | 1420 W. Donald St, Waterloo, IA 50703 | 2017-08-25 |
| 1215359054 | Chuck Corwin | Counselor | 607 Sycamore Street, Suite 300, Waterloo, IA 50703 | 2014-01-14 |
| 1679672554 | Linda D Bartollas | Social Worker | 146 West Dale Street, Suite 101, Waterloo, IA 50703 | 2006-09-21 |
| 1558477745 | Brent Matthew Hintz | Obstetrics & Gynecology | 212 West Dale St., Suite 402, Waterloo, IA 50703 | 2006-08-21 |
| 1588629729 | Mir Ahmad Waziri | Pediatrics | 212 W Dale Street, Suite 302, Waterloo, IA 50703 | 2006-04-19 |
| 1568432615 | Wei Yang | Pathology | Northeast Iowa Pathology Associates, PC, 1825 Logan Avenue, Waterloo, IA 50703 | 2006-01-23 |
| 1689158040 | Megan Elizabeth O'neal | Nurse Practitioner | 1631 Logan Ave, Waterloo, IA 50703 | 2018-09-21 |
| 1972031359 | Stephanie Rose Smith | Nurse Practitioner | 1631 Logan Ave, Waterloo, IA 50703 | 2017-05-30 |
| 1801263462 | Krissy Jean Wieland | Nurse Practitioner | 220 Franklin St, Waterloo, IA 50703 | 2015-08-28 |
| 1699169698 | Jens Masters Olsen | Emergency Medicine | 1825 Logan Ave, Waterloo, IA 50703 | 2015-03-27 |
| Find all providers in zip 50703 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134696255 | Caleb Hess | Psychologist | 3261 University Ave, Waterloo, IA 50701-2051 | 2018-10-26 |
| 1487750261 | Lindsey Welker | Psychologist | 988 N Illinois Route 3, Waterloo, IL 62298-1000 | 2006-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952966533 | Bridges Community Services, LLC | Psychologist | 110 Nw 2nd St, Stuart, IA 50250 | 2019-05-08 |
| 1659873727 | Willow Grove Therapy Group LLC | Psychologist | 5000 Westown Pkwy Ste 100, West Des Moines, IA 50266-5921 | 2018-03-05 |
| 1295248326 | Kristen Nicole Sievert | Psychologist | 4720 Mortensen Rd Ste 104, Ames, IA 50014-5534 | 2017-11-11 |
| 1609320902 | Summer K. Brunscheen, LLC | Psychologist | 2515 University Blvd Ste 102, Ames, IA 50010-8628 | 2016-08-04 |
| 1235513011 | Sheila Pogge | Psychologist | 520 10th Ave Lowr Level, Coralville, IA 52241-1910 | 2015-07-12 |
| 1861814428 | Nathaniel Wade | Psychologist | 2613 Northridge Pkwy, Suite 105, Ames, IA 50010-4096 | 2014-01-15 |
| 1023367018 | Michelle Leigh Cushman | Psychologist | 431 28th St Ste 204, Des Moines, IA 50312-4400 | 2012-09-05 |
| 1548563901 | Davis Psychological Services, PC | Psychologist | 821 5th Ave, Suite 201, Grinnell, IA 50112-1653 | 2010-12-07 |
| 1104148485 | Evergreen Psychological Services | Psychologist | 313 College Ave, Oskaloosa, IA 52577-1700 | 2010-02-27 |
| 1598988024 | Eugene R Deisinger | Psychologist | 2521 Elwood Dr Ste 121, Ames, IA 50010-8229 | 2007-04-11 |
| Find all providers with the same taxonomy | ||||
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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.