SUSANNA CICCOLARI MICALDI (NPI# 1790190791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790190791 |
Entity Type | Individual |
Full Name | SUSANNA CICCOLARI MICALDI |
Credential | MD |
Practice Address |
1001 N. Minneapolis St Wichita KS 67214-3127 |
Mailing Address |
1001 N Minneapolis St Wichita KS 67214-3127 |
Practice Telephone | 3162932647 |
Practice Fax Number | 8554760305 |
Mailing Telephone | 3162932647 |
Mailing Fax Number | 8554760305 |
Enumeration Date | 2014-06-27 |
Last Update Date | 2019-11-13 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
94-08402 | KS | Allopathic & Osteopathic Physicians |
Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
94-08402 | KS | Allopathic & Osteopathic Physicians |
Street Address |
1001 N. MINNEAPOLIS ST |
City | WICHITA |
State | KS |
Zip Code | 67214-3127 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124591185 | Laquita Patrice Boyede | Durable Medical Equipment & Medical Supplies | 1503 Northeast Parkway, Wichita, KS 67214 | 2019-01-02 |
1891270674 | Kathryn Denise Boomer | Physician Assistant | 929 St. Francis N, Wichita, KS 67214 | 2018-09-27 |
1447756457 | Cardinal Health 132 LLC | Pharmacy | 527 N Grove Street, Suite 100, Wichita, KS 67214 | 2018-03-30 |
1023517174 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 3243 E Murdock Street, Level G, Wichita, KS 67214 | 2018-02-05 |
1558887901 | Shonnetta Lachan Gabriel | Counselor | 2707 E. 21st St. N, Wichita, KS 67214 | 2017-08-17 |
1417492174 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 803 N Broadway Ave, Wichita, KS 67214 | 2017-01-04 |
1952850653 | Rachel J Johnson | Counselor | 805 N Volutsia, Wichita, KS 67214 | 2016-09-23 |
1063899813 | Christy Lee Foos | Social Worker | 2707 E. 21st St. North, Healthcore Clinic, Wichita, KS 67214 | 2015-04-30 |
1952708018 | William Schroeder Fargo | Specialist | 701 N. Emporia, Wichita, KS 67214 | 2014-12-04 |
1447692710 | Valeriya V Hunter | Dentist | 527 N Grove, Wichita, KS 67214 | 2013-07-26 |
Find all providers in zip 67214 |
Taxonomy Code | 2084P0804X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Child & Adolescent Psychiatry |
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659633709 | Larry David Mitnaul Jr. | Psychiatry & Neurology | 1515 S Clifton Ave Ste 300, Wichita, KS 67218-2953 | 2012-06-14 |
1235344433 | Mathias James Lillig | Psychiatry & Neurology | 1001 N Minneapolis St, Wichita, KS 67214-3127 | 2007-05-11 |
1265416499 | Kimberly J Pankow | Psychiatry & Neurology | 5500 E Kellogg Dr, Bh, Wichita, KS 67218-1607 | 2005-12-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760652531 | Robert Seth Gordon | Psychiatry & Neurology | 611 S Kansas Ave Ste 101, Topeka, KS 66603 | 2008-03-07 |
1902945934 | Mwendalubi Yasa | Psychiatry & Neurology | 1901 East First Street, Prairie View, Newton, KS 67114-0467 | 2007-02-06 |
1871639799 | Kansas University Physicians Inc | Psychiatry & Neurology | 1088 Delp Pavilion, Mail Stop 4015 3901 Rainbow Blvd, Kansas City, KS 66160 | 2007-01-29 |
1306996434 | Poonam Khanna | Psychiatry & Neurology | 14221 Metcalf Ave, Suite 123, Overland Park, KS 66223-3344 | 2007-01-11 |
1225067655 | M David Brown | Psychiatry & Neurology | 8300 College Blvd Ste 320, Overland Park, KS 66210-2814 | 2006-06-30 |
1629510417 | Wexler Family Psychiatry | Psychiatry & Neurology | 4203 Booth St, Kansas City, KS 66103-3116 | 2016-11-09 |
1548680507 | Caitlin Mellencamp Winder | Psychiatry & Neurology | 8000 W 127th St, Overland Park, KS 66213-2714 | 2014-04-17 |
1821346495 | Stacey Allison Laird | Psychiatry & Neurology | 4121 W 83rd St, Suite 204, Prairie Village, KS 66208-5472 | 2012-08-29 |
1851646285 | Anthony Anunwa Md Pa | Psychiatry & Neurology | 1600 N Lorraine St, Hutchinson, KS 67501-5670 | 2012-07-23 |
1164784963 | Daniel J Tseng | Psychiatry & Neurology | 650 Huebner Rd, Fort Riley, KS 66442 | 2012-06-08 |
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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.