Bhasker Jethalal Dave, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

18590 Issued in IA

Practice address

2277 Iowa Ave
Independence, IA 50644-9106

Phone

(319) 334-2583

Fax

(319) 334-5252

NPI assigned

Aug 31, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mental Health Institute

  • Psychiatric Hospital
  • Independence, IA
  • NPI 1013066430
  Authorized official Same address or phone
• Mental Health Institute

  dba Psychiatric Phsycians Services

  • Psychiatry Physician
  • Independence, IA
  • NPI 1023069440
  Authorized official Same address or phone
• Mental Health Institute

  dba Imhi-Pmic

  • Psychiatric Residential Treatment Facility
  • Independence, IA
  • NPI 1205911765
  Authorized official Same address or phone
• Mental Health Institute

  • Psychiatric Hospital
  • Independence, IA
  • NPI 1841279239
  NPD (past) Authorized official
• Black Hawk-Grundy Mental Health Center Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waterloo, IA
  • NPI 1316944598
  NPD (past)
• United Community Services, Inc.

  • Point of Service
  • West Des Moines, IA
  • NPI 1609998137
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1679684641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2277 IOWA AVE",
            "city": "INDEPENDENCE",
            "state": "IA",
            "postal_code": "506449106",
            "telephone_number": "319-334-2583",
            "fax_number": "319-334-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2277 IOWA AVE",
            "city": "INDEPENDENCE",
            "state": "IA",
            "postal_code": "506449106",
            "telephone_number": "319-334-2583",
            "fax_number": "319-334-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVE",
        "first_name": "BHASKER",
        "middle_name": "JETHALAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "18590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0096891",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Changing Leaf Counseling
• Muhammad Afzal Chowdhry, MD
• Cornerstone Family Therapy, LLC
• Counseling and Assessment Service, PC
• County of Buchanan (Buchanan County Ambulance Service)
• Randolfo De Leon, M.D.
• Kimberly Deterding, LAC; LMT
• Sarah Rae Devore, ARNP
• Connie R Divis, RPH
• Dr Mark M Zimmer PC (Belle Plaine Family Eyecare)

• Psychiatry Physician in Independence, IA
• Providers in Independence, IA by specialty
• Psychiatry Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.