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C/O RAMIRO ICAZA
NPI 1790818599
Family Medicine in Cape Girardeau, MO

Active since March 13, 2007CLIA 26D2171414 · Waiver
304 S MOUNT AUBURN RD, CAPE GIRARDEAU, MO 63703(573) 803-3331(573) 803-2905 Get Directions Write a Review

NPPES record last updated: February 6, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About C/o Ramiro Icaza NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

C/O RAMIRO ICAZA (NPI 1790818599) is a healthcare organization registered as a family medicine in Cape Girardeau, Missouri and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through August 28, 2027 and lists Ramiro Icaza, Administrator, as its authorized official.

NPPES Registry Identity

NPI1790818599
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameALLIANCE HEALTH & DERMATOLOGY
Location Address304 S MOUNT AUBURN RDCape Girardeau, MO 63703-4920
Mailing Address304 S Mount Auburn RdCape Girardeau, MO 63703-4920 · (573) 803-3331 · Fax (573) 243-3400
Phone(573) 803-3331
Fax(573) 803-2905
Organization SubpartNo
Authorized OfficialRamiro IcazaAdministrator · (573) 243-2154
Enumeration DateMarch 13, 2007
Last NPPES UpdateFebruary 6, 2020
✔ NPI 1790818599 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MO · MDR7D79
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
304 S MOUNT AUBURN RD, Cape Girardeau, MO 63703
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Other Names 1

Other NameC/o Ramiro Icaza

Other Identifiers 1

Medicaid593695703MO

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D2171414

Alliance Health And Dermatology LLC · Cape Girardeau, MO
Active · expires Aug 28, 2027
CLIA Number26D2171414
Laboratory TypePhysician Office
Certificate Effective DateAugust 29, 2025
Certificate Expiration DateAugust 28, 2027
Laboratory DirectorJosh Gast
Laboratory Phone(573) 803-3331
Laboratory LocationAlliance Health And Dermatology LLC304 S Mt Auburn Road, Cape Girardeau, MO 63703
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PAM J HIETT
Registered Nurse (Registered Nurse First Assistant)
304 S MOUNT AUBURN RD
CAPE GIRARDEAU, MO 63703
Cape Girardeau County (573) 651-1687
MS. MARY ELIZABETH JARRELLS FNP-BC
Nurse Practitioner (Family)
304 S MOUNT AUBURN RD
CAPE GIRARDEAU, MO 63703
Cape Girardeau County (573) 651-1687
SUJITHA YADLAPATI MD
Dermatology
304 S MOUNT AUBURN RD
CAPE GIRARDEAU, MO 63703
Cape Girardeau County (573) 803-3331
DSMEDICAL, LLC
Durable Medical Equipment & Medical Supplies
304 S MOUNT AUBURN RD
CAPE GIRARDEAU, MO 63703
Cape Girardeau County (573) 270-8576
ASHLEY CAMP PA-C
Surgery
304 S MOUNT AUBURN RD
CAPE GIRARDEAU, MO 63703
Cape Girardeau County (573) 651-1687
MRS. MARILYN J JANSEN PA-C
Physician Assistant (Surgical)
304 S MOUNT AUBURN RD
CAPE GIRARDEAU, MO 63703
Cape Girardeau County (573) 334-9933
CAPE NEUROLOGICAL SURGEONS, P. C.
Specialist
304 S MOUNT AUBURN RD
CAPE GIRARDEAU, MO 63703
Cape Girardeau County (573) 334-9933
DR. KAKEUNG CHARLES CHEUNG MD
Specialist
304 S MOUNT AUBURN RD
CAPE GIRARDEAU, MO 63703
Cape Girardeau County (573) 334-9933

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Alliance Health & Dermatology's NPI number?

The NPI number for Alliance Health & Dermatology is 1790818599. It was assigned to this organization in the NPPES registry on March 13, 2007. The provider is also known as C/O Ramiro Icaza.

Where is Alliance Health & Dermatology located?

Alliance Health & Dermatology is located at 304 S Mount Auburn Rd, Cape Girardeau, MO 63703. The listed phone number is (573) 803-3331.

What is Alliance Health & Dermatology's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Alliance Health & Dermatology hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D2171414) is associated with this NPI, valid through August 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Alliance Health & Dermatology was last updated on February 6, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.