EDWARD W PEGG III (NPI# 1043392160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043392160 |
| Entity Type | Individual |
| Full Name | EDWARD W PEGG III |
| Credential | MD |
| Practice Address |
1505 Eastland Dr Suite 2400 Bloomington IL 61701-3534 |
| Practice Telephone | 3096617344 |
| Practice Fax Number | 3096617343 |
| Mailing Telephone | 3096617344 |
| Mailing Fax Number | 3096617343 |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
036071077 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036071077 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215273131 | Edward William Pegg Iv | Psychiatry & Neurology | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2012-12-20 |
| Street Address |
1505 EASTLAND DR SUITE 2400 |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61701-3534 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336142017 | Yogesh K Agarwal | Internal Medicine | 1505 Eastland Dr, Ste 330, Bloomington, IL 61701-3534 | 2005-05-24 |
| 1073082384 | Caroline J Turner | Nurse Practitioner | 1505 Eastland Dr, Bloomington, IL 61701-3534 | 2018-11-15 |
| 1548755366 | Sunanda R Kale | Nurse Practitioner | 1505 Eastland Dr, Bloomington, IL 61701-3534 | 2018-06-25 |
| 1790294403 | Sarah Kneip | Nurse Practitioner | 1505 Eastland Dr, Bloomington, IL 61701-3534 | 2017-09-26 |
| 1760909626 | Hannah K Corley | Nurse Practitioner | 1505 Eastland Dr, Bloomington, IL 61701-3534 | 2017-08-23 |
| 1467827592 | Kelly Karr | Registered Nurse | 1505 Eastland Dr, Bloomington, IL 61701-3534 | 2015-12-01 |
| 1205219607 | Michele Krieger-johnsen | Nurse Practitioner | 1505 Eastland Dr, Bloomington, IL 61701-7905 | 2015-07-02 |
| 1326420563 | Fresenius Medical Care Normal, LLC | Clinic/Center | 1505 Eastland Dr, Medical Plaza Lower Level, Bloomington, IL 61701-3534 | 2015-06-24 |
| 1588068803 | Allison Vogel | Physician Assistant | 1505 Eastland Dr, Bloomington, IL 61701-3534 | 2014-10-15 |
| 1578964987 | Kristin N Wilkins | Clinical Nurse Specialist | 1505 Eastland Dr, Suite 320, Bloomington, IL 61701-3534 | 2014-09-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770140964 | County of Mclean | Community/Behavioral Health | 200 W Front St, 1st Floor Sw, C/o 200 W Front St, Suite 400f, Bloomington, IL 61701 | 2019-05-22 |
| 1023525292 | Karli Johnson | Counselor | 200 W Monroe St Ste C7, Bloomington, IL 61701 | 2018-01-09 |
| 1487172409 | Melody Ann Bauman | Physician Assistant | 1505 Eastland Dr, Osf Critical Cane, Pulmonary, Sleep M, Bloomington, IL 61701 | 2017-08-30 |
| 1215396288 | Heidi Larsen | Social Worker | 902 S East St, Bloomington, IL 61701 | 2016-02-18 |
| 1558735126 | Andrea E. Andrews Counseling LLC | Counselor | 200 W. Monroe St., Ste 302 C, Bloomington, IL 61701 | 2015-11-19 |
| 1174924856 | Carole Hahn | Dietitian, Registered | 1406 Forrest St, Bloomington, IL 61701 | 2014-09-12 |
| 1558786392 | Valerie Colleen Parker | Counselor | 109 W. Mulberry St., Bloomington, IL 61701 | 2014-03-04 |
| 1124459219 | Matilde Francois | Surgery | 1505 Eastland Dr Ste 2300, Bloomington, IL 61701 | 2013-11-27 |
| 1922435114 | Smitha H Shivaprasad | Pharmacist | 2611 East Oakland Avenue, Bloomington, IL 61701 | 2013-10-02 |
| 1295161941 | Ashvin Patel | Obstetrics & Gynecology | 31 Country Club Pl, Bloomington, IL 61701 | 2013-09-25 |
| Find all providers in zip 61701 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083848550 | David W Harvey | Psychiatry & Neurology | 321 S Landmark Ave, Bloomington, IN 47403-5001 | 2009-05-12 |
| 1568667772 | Edward W Pegg Md, LLC | Psychiatry & Neurology | 1505 Eastland Dr Ste 2400, Bloomington, IL 61701-7911 | 2007-06-18 |
| 1245248293 | Jameson Daniel Way | Psychiatry & Neurology | 2315 E 3rd St, Bloomington, IN 47401-5320 | 2006-08-04 |
| 1760431712 | Mclean County Neurology Sc | Psychiatry & Neurology | 2204 Eastland Dr, Bloomington, IL 61704-3566 | 2006-05-08 |
| 1689150948 | Barbara Luann Weis | Psychiatry & Neurology | 1701 E College Ave, Bloomington, IL 61704-2101 | 2018-07-18 |
| 1770038069 | Supriya Kairamkonda | Psychiatry & Neurology | 583 S Clarizz Blvd, Bloomington, IN 47401-5515 | 2016-08-17 |
| 1336403237 | Derrick Alwyn Fox | Psychiatry & Neurology | 1701 E College Ave, Bloomington, IL 61704-2101 | 2012-06-26 |
| 1477875938 | Mehyar Mehrizi | Psychiatry & Neurology | 583 S Clarizz Blvd, Bloomington, IN 47401-5515 | 2010-02-24 |
| 1326233271 | Barry Jay Riskin | Psychiatry & Neurology | 2502 E Empire St, Bloomington, IL 61704-3738 | 2007-09-12 |
| 1194865642 | Neurology Specialists, PC | Psychiatry & Neurology | 813 W 2nd St, Bloomington, IN 47403-2212 | 2007-02-07 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 61701 |
Please comment or provide details below to improve the information on EDWARD W PEGG III.
| 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.