KELLY JESTER GELDMACHER (NPI# 1043327554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043327554 |
| Entity Type | Individual |
| Full Name | KELLY JESTER GELDMACHER |
| Credential | M.D. |
| Practice Address |
6800 State Route 162 Maryville IL 62062-8500 |
| Mailing Address |
4075 Copper Ridge Dr Traverse City MI 49684-7059 |
| Practice Telephone | 6183915711 |
| Mailing Telephone | 8002535358 |
| Mailing Fax Number | 2319324134 |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2009-11-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 036112201 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036112201-4 | 05 |
| Street Address |
6800 STATE ROUTE 162 |
| City | MARYVILLE |
| State | IL |
| Zip Code | 62062-8500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588666804 | Legatus Emergency Services LLC | Emergency Medicine | 6800 State Route 162, Maryville, IL 62062-8500 | 2005-06-01 |
| 1598373052 | Brittany Smith | Nurse Anesthetist, Certified Registered | 6800 State Route 162, Maryville, IL 62062-8500 | 2020-07-21 |
| 1285251033 | Cory Ray Austin | Nurse Anesthetist, Certified Registered | 6800 State Route 162, Maryville, IL 62062-8500 | 2020-06-28 |
| 1043856701 | Mallory Jean Stimac | Physician Assistant | 6800 State Route 162, Maryville, IL 62062-8521 | 2019-11-18 |
| 1023577442 | Christie Marie Keen | Nurse Practitioner | 6800 State Route 162, Maryville, IL 62062-8521 | 2019-03-15 |
| 1437623287 | Teressa Vigil | Occupational Therapist | 6800 State Route 162, Maryville, IL 62062-8500 | 2019-01-15 |
| 1891268355 | Eric Michael Watson | Physician Assistant | 6800 State Route 162, Maryville, IL 62062-8521 | 2019-01-08 |
| 1649748831 | Mary Holowatuk | Occupational Therapist | 6800 State Route 162, Maryville, IL 62062-8521 | 2018-11-06 |
| 1558846741 | Cori Warren | Occupational Therapist | 6800 State Route 162, Maryville, IL 62062-8500 | 2018-10-03 |
| 1134604366 | Anna Mcnamara | Physical Therapist | 6800 State Route 162, Maryville, IL 62062-8500 | 2018-10-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104325091 | Jennifer M Oyler | Physician Assistant | 6812 State Route 162 Suite 120, Maryville, IL 62062 | 2018-02-06 |
| 1710495965 | Sarah Elizabeth Barto | Family Medicine | 2133 Vadalabene Drive, Suite Sb, Maryville, IL 62062 | 2018-01-22 |
| 1104348085 | Lindsey Nicole Langendorf | Chiropractor | 62 Executive Plaza Ct, Maryville, IL 62062 | 2017-07-12 |
| 1043750540 | Gina Saal | Nurse Anesthetist, Certified Registered | 6800 Rt 162, Maryville, IL 62062 | 2017-03-02 |
| 1548657737 | Karen Michelle Bertels | Emergency Medicine | 6800 Il - 162, Maryville, IL 62062 | 2015-04-25 |
| 1811258148 | Debra Ann Hoelscher | Internal Medicine | 2102 Vadalabene, Maryville, IL 62062 | 2012-06-04 |
| 1538438445 | Casey Elizabeth Wiesemeyer | Speech-Language Pathologist | 2201 Copper Creek Rd, Maryville, IL 62062 | 2011-12-21 |
| 1407144819 | Norah Claire Farley Baker | Family Medicine | 10 Professional Park Dr., Maryville, IL 62062 | 2011-07-19 |
| 1891092474 | Kimberly M Schneider | Physician Assistant | 20b Professional Park Drive, Maryville, IL 62062 | 2011-02-17 |
| 1669782397 | Purandhri Patel | Physical Therapist | 6820 State Route 162, Maryville, IL 62062 | 2010-10-15 |
| Find all providers in zip 62062 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548657737 | Karen Michelle Bertels | Emergency Medicine | 6800 Il - 162, Maryville, IL 62062 | 2015-04-25 |
| 1407299126 | Jeffrey Allyn Hassenflug | Emergency Medicine | 2081 Briarbend Ct, Maryville, IL 62062-5833 | 2013-04-11 |
| 1598841025 | Haresh K Motwani | Emergency Medicine | 2133 Vadalabene Dr, Suite # 5b, Maryville, IL 62062-5839 | 2006-10-27 |
| 1710910211 | Samuel Burch Cheek Jr. | Emergency Medicine | 427 Broadmoor Dr, Maryville, TN 37803-6583 | 2006-07-08 |
| 1821065764 | Michael E Mandis | Emergency Medicine | 2236 Vadalabene Dr, Suite 2, Maryville, IL 62062-5844 | 2006-02-28 |
| 1760465165 | Peter B Malench | Emergency Medicine | 10 Professional Park Dr, Maryville, IL 62062-5672 | 2005-11-21 |
| 1588666804 | Legatus Emergency Services LLC | Emergency Medicine | 6800 State Route 162, Maryville, IL 62062-8500 | 2005-06-01 |
| 1679990733 | Emergency Practice Associates, Inc. | Emergency Medicine | 2016 S Main St, Maryville, MO 64468-2655 | 2014-03-26 |
| 1891006771 | Ryan Neal Joshi | Emergency Medicine | 907 E Lamar Alexander Pkwy, Maryville, TN 37804-5015 | 2010-06-25 |
| 1255503587 | Lisa Parke Maier | Emergency Medicine | 6800 State Route 162, Department of Emergency Medicine, Maryville, IL 62062-8500 | 2008-03-27 |
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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.