STEPHEN H JENNISON (NPI# 1043391766) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043391766 |
| Entity Type | Individual |
| Full Name | STEPHEN H JENNISON |
| Credential | M.D. |
| Practice Address |
619 E Mason St Suite 4p57 Springfield IL 62701-1034 |
| Mailing Address |
Po Box 19420 Springfield IL 62794-9420 |
| Practice Telephone | 2177880706 |
| Practice Fax Number | 2175252535 |
| Mailing Telephone | 2177880706 |
| Mailing Fax Number | 2175252535 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2008-06-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 036-091807 | IL | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | RAILROAD | 060031123 | 01 |
| Street Address |
619 E MASON ST SUITE 4P57 |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62701-1034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033190814 | Carl E Arentzen | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 619 E Mason St, Suite 3p25, Springfield, IL 62701-1034 | 2005-11-09 |
| 1669913349 | Laura Grubb | Internal Medicine | 619 E Mason St, Ste. 4p57, Springfield, IL 62701-1034 | 2017-03-15 |
| 1265974604 | Julie Borjon | Internal Medicine | 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 | 2016-11-16 |
| 1912358565 | Meleah Vaughan | Nurse Practitioner | 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 | 2016-06-24 |
| 1508225616 | Margaret Jordan | Internal Medicine | 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 | 2016-02-17 |
| 1487011144 | Shauna Vogler | Internal Medicine | 619 E Mason St, Springfield, IL 62701-1034 | 2016-01-25 |
| 1871987750 | Amy Durako | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 | 2015-03-27 |
| 1215333604 | Meredith Fleming | Internal Medicine | 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 | 2014-11-12 |
| 1154623585 | Margie Douglas | Nurse Practitioner | 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 | 2010-11-17 |
| 1326378175 | Angela K. Lafrenz | Internal Medicine | 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 | 2009-12-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932687183 | Affinity Patient Coordination LLC | In Home Supportive Care | 217 E Monroe St Ste 102, Springfield, IL 62701 | 2018-07-31 |
| 1427498435 | Donald L Jacoby | Pharmacist | 701 N. First St., Springfield, IL 62701 | 2013-07-05 |
| 1700183480 | Erin Zepp | Dietitian, Registered | 319 E Madison St Ste 1f, Springfield, IL 62701 | 2011-02-16 |
| 1518117159 | Jyoti Assudani | Pediatrics | 301 N 8th Street, Springfield, IL 62701 | 2008-09-19 |
| 1396924148 | Jeanne Lyn Malone | Counselor | 408 South Fifth Street, Springfield, IL 62701 | 2007-10-29 |
| 1942422928 | Nobuharu Harada | Family Medicine | 301 N 8th, Pav-3a158, Springfield, IL 62701 | 2007-05-02 |
| 1427131127 | Radiological Associates of Decatur | Radiology | 319 E Madison Suite J, Springfield Mri & Imaging Center, Springfield, IL 62701 | 2006-10-24 |
| 1669498606 | Independence Holding Co LLC | Pharmacy | 201 North 5th Street, Springfield, IL 62701 | 2006-07-14 |
| 1720070238 | Neil J. Thomas | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 619 E Mason St Ste 4p57, Springfield, IL 62701 | 2005-08-19 |
| 1588187397 | Andrea Nicole Bloodworth | Internal Medicine | 619 E Mason St Ste 4p57, Springfield, IL 62701 | 2017-07-24 |
| Find all providers in zip 62701 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
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| 1659771350 | Ronnie L. Jackson Md | Specialist | 496 Northcrest Dr, Springfield, TN 37172-3972 | 2014-08-29 |
| 1659781136 | Ashley Foucha | Specialist | 1342 E Primrose St Ste A, Springfield, MO 65804-4224 | 2014-05-05 |
| 1225452881 | Elizabeth Creps | Specialist | 1623 21st St Ste B, Springfield, OR 97477-3417 | 2014-02-18 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62701 |
Please comment or provide details below to improve the information on STEPHEN H JENNISON.
| 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.