DUBUQUE PAIN CLINIC (NPI# 1467863472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467863472 |
| Entity Type | Organization |
| Organization Name | DUBUQUE PAIN CLINIC |
| Practice Address |
250 Mercy Dr Dubuque IA 52001-7320 |
| Mailing Address |
2260 Samantha Dr Dubuque IA 52002-0485 |
| Practice Telephone | 5635898665 |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2014-05-13 |
| Authorized Official Name | IVAN FOMITCHEV (PRESIDENT) |
| Authorized Official Telephone | 5635641283 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
34875 | IA | Allopathic & Osteopathic Physicians |
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
34875 | IA | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | DUBUQUE PAIN CLINIC, LLC | 2100 Asbury Rd Suite 8, Dubuque, IA 52001 |
| Street Address |
250 MERCY DR |
| City | DUBUQUE |
| State | IA |
| Zip Code | 52001-7320 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942293220 | Stephen Michael Clifford | Radiology | 250 Mercy Dr, Dubuque, IA 52001-7320 | 2005-08-23 |
| 1245846682 | Mercy Health Services-iowa, Corp | Clinical Medical Laboratory | 250 Mercy Dr, Dubuque, IA 52001-7320 | 2020-09-21 |
| 1972118578 | Brett Becker | Pharmacist | 250 Mercy Dr, Dubuque, IA 52001-7320 | 2020-09-10 |
| 1205465473 | Erin Bailey | Pharmacist | 250 Mercy Dr, Dubuque, IA 52001-7320 | 2020-04-08 |
| 1295211761 | Ashley Marie Biedermann | Nurse Practitioner | 250 Mercy Dr, Dubuque, IA 52001-7320 | 2018-07-17 |
| 1487171526 | Martha Levy | Nurse Practitioner | 250 Mercy Dr, Dubuque, IA 52001-7320 | 2017-08-29 |
| 1508386160 | Christopher Edward Little | Family Medicine | 250 Mercy Dr, Dubuque, IA 52001-7320 | 2017-06-26 |
| 1235669995 | Nathaniel William Rojemann | Nurse Practitioner | 250 Mercy Dr, Dubuque, IA 52001-7320 | 2017-06-15 |
| 1306397401 | Rocky Mountain Holdings, LLC | Ambulance | 250 Mercy Dr, Dubuque, IA 52001 | 2016-10-24 |
| 1881040269 | Frederick Osborne Liaboe | Emergency Medicine | 250 Mercy Dr, Dubuque, IA 52001-7320 | 2016-05-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992291132 | Klauer Optometry PC | Optometrist | 1705 Delhi St Uppr Level, Dubuque, IA 52001 | 2018-07-10 |
| 1710496427 | Ryan Michael Chatfield | Counselor | 799 Main St. Suite 110, Dubuque, IA 52001 | 2017-09-26 |
| 1396274791 | Patricia Ochs | Social Worker | 200 Mercy Dr., Ste. 200, Dubuque, IA 52001 | 2017-06-08 |
| 1770025264 | Young Men's Christian Association of Dubuque, Iowa | Health Educator | 35 North Booth Street, Dubuque, IA 52001 | 2016-11-15 |
| 1912388786 | Benjamin N Baker | Nurse Anesthetist, Certified Registered | 1515 Delhi Street, Suite 300, Mississippi Valley Anesthesiology, Dubuque, IA 52001 | 2015-06-17 |
| 1437536752 | Lucas Stephen Flamich | Optometrist | 300 N Grandview Ave., Dubuque, IA 52001 | 2015-05-06 |
| 1386067635 | Mississippi Valley Anesthesiology | Anesthesiology | 350 Grandview Avenue, Dubuque, IA 52001 | 2014-01-22 |
| 1376815209 | Umeka Latasha Lewis | Adult Companion | 1308 1/2 Jackson St, Dubuque, IA 52001 | 2012-02-08 |
| 1861777450 | Kevin Joseph Natzke | Pharmacist | 250 Mercy Drvie, Mercy Family Pharmacy, Dubuque, IA 52001 | 2011-10-15 |
| 1316231012 | Radiation Oncology of Iowa, PC | Radiology | 350 North Grandview Avenue, Dubuque, IA 52001 | 2011-05-31 |
| Find all providers in zip 52001 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114266749 | Mid-american Anesthesia and Pain PC | Pain Medicine | 4500 Utica Ridge Rd, Bettendorf, IA 52722-1626 | 2013-02-01 |
| 1477793909 | Ms Iqbal Md PC | Pain Medicine | 330 Laurel St, Ste. 1300, Des Moines, IA 50314-3034 | 2009-02-24 |
| 1235137340 | Mohammad S Iqbal | Pain Medicine | 330 Laurel St, Ste 1300, Des Moines, IA 50314-3034 | 2005-07-12 |
Please comment or provide details below to improve the information on DUBUQUE PAIN CLINIC.
| 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.