1558568469 NPI number — DR. MEGAN MICHELLE ADAMS RIECK PHD

Table of content: DR. MEGAN MICHELLE ADAMS RIECK PHD (NPI 1558568469)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558568469 NPI number — DR. MEGAN MICHELLE ADAMS RIECK PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ADAMS RIECK
Provider First Name:
MEGAN
Provider Middle Name:
MICHELLE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ADAMS
Provider Other First Name:
MEGAN
Provider Other Middle Name:
MICHELLE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1558568469
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/29/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1026 A AVE NE
Provider Second Line Business Mailing Address:
ST LUKE'S HOSPITAL PHYSICAL MEDICINE AND REHABILITATION
Provider Business Mailing Address City Name:
CEDAR RAPIDS
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52402-5036
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
319-369-7331
Provider Business Mailing Address Fax Number:
319-369-8251

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1026 A AVE NE
Provider Second Line Business Practice Location Address:
ST LUKE'S HOSPITAL PM & R DEPT
Provider Business Practice Location Address City Name:
CEDAR RAPIDS
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-369-7331
Provider Business Practice Location Address Fax Number:
319-369-8251
Provider Enumeration Date:
07/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103G00000X , with the licence number:  074683 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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