AMY J STITES (NPI# 1043676109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043676109 |
| Entity Type | Individual |
| Full Name | AMY J STITES |
| Credential | PA-C |
| Practice Address |
1302 Franklin Ave Suite 4800 Normal IL 61761-3551 |
| Practice Telephone | 3094545900 |
| Practice Fax Number | 3094542820 |
| Mailing Telephone | 3094545900 |
| Mailing Fax Number | 3094542820 |
| Enumeration Date | 2016-01-05 |
| Last Update Date | 2016-03-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085005783 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1302 FRANKLIN AVE SUITE 4800 |
| City | NORMAL |
| State | IL |
| Zip Code | 61761-3551 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063419679 | John D Fulk | Physician Assistant | 1302 Franklin Ave, Suite 4800, Normal, IL 61761-3551 | 2005-06-29 |
| 1235686759 | Brooke Davis | Nurse Practitioner | 1302 Franklin Ave, Suite 4800, Normal, IL 61761-3551 | 2016-09-01 |
| 1255700316 | Abigail G Cervantes | Obstetrics & Gynecology | 1302 Franklin Ave, Suite 2800, Normal, IL 61761-6526 | 2015-09-18 |
| 1700252228 | Prairieland Outpatient Diagnostic Center, LLC | Anesthesiology | 1302 Franklin Ave, Suite 1000, Normal, IL 61761-3551 | 2015-08-19 |
| 1467860445 | Christie Rocke | Nurse Practitioner | 1302 Franklin Ave, Suite 3400, Normal, IL 61761-3551 | 2014-07-23 |
| 1114343225 | Jennifer Lanz | Nurse Practitioner | 1302 Franklin Ave, Suite 4500, Normal, IL 61761-3551 | 2014-03-13 |
| 1396189411 | Consulting Anesthesiologists LLC | Anesthesiology | 1302 Franklin Ave, Normal, IL 61761-3551 | 2013-04-19 |
| 1285903799 | Bromenn Physicians Management Corporation | Counselor | 1302 Franklin Ave, Suite 1100, Normal, IL 61761-3551 | 2011-12-29 |
| 1922377431 | Bromenn Physicians Management Corporation | Internal Medicine | 1302 Franklin Ave, Suite 4500, Normal, IL 61761-3551 | 2011-12-29 |
| 1033494455 | Maneesha T Joseph | Registered Nurse | 1302 Franklin Ave, Suite 3400, Normal, IL 61761-3551 | 2011-10-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681796 | Brittany Nicole Mekley | Nurse Practitioner | 201 N. University, Normal, IL 61761 | 2020-08-28 |
| 1679108971 | Krystal Halliday | Occupational Therapist | 1815 N Towanda Barnes Rd, Normal, IL 61761 | 2020-03-06 |
| 1265915474 | Laine E Burek | Nurse Practitioner | 1765 Bradford Ln., Normal, IL 61761 | 2018-09-13 |
| 1801389986 | Ashley Michelle James | Specialist/Technologist | 347 S. University St, Normal, IL 61761 | 2018-06-12 |
| 1447750708 | Shelley R. Ruch | Specialist/Technologist, Other | 1604 Visa Drive, Ste 1, Normal, IL 61761 | 2018-02-13 |
| 1497275069 | Mclean County Nursing Home | Non-emergency Medical Transport (VAN) | 901 N. Main St, Normal, IL 61761 | 2017-06-23 |
| 1235673666 | Megan Threm | Registered Nurse | 900 Franklin Ave Community Health Care Clinic, Normal, IL 61761 | 2016-12-04 |
| 1437513553 | Tiesha Smith | Specialist | 1800 Rockingham Dr, Apt 1d, Normal, IL 61761 | 2016-04-06 |
| 1285031658 | New Day Recovery | Community/Behavioral Health | 402 Summit, Normal, IL 61761 | 2014-12-01 |
| 1174927701 | Alyssa Marie Bruck | Occupational Therapist | 700 N Walnut St, Normal, IL 61761 | 2014-10-10 |
| Find all providers in zip 61761 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063024388 | Alyson Dyck | Physician Assistant | 2540 Health Services, Ssb Student Services Building, Normal, IL 61790-2540 | 2020-08-18 |
| 1699968602 | Anastasia Seeram | Physician Assistant | 1604 Visa Dr., Ste 1, Normal, IL 61761 | 2007-08-22 |
| 1790721298 | Dana Dalbak | Physician Assistant | 2010 Jacobssen Dr, Normal, IL 61761-6280 | 2006-06-22 |
| 1063419679 | John D Fulk | Physician Assistant | 1302 Franklin Ave, Suite 4800, Normal, IL 61761-3551 | 2005-06-29 |
| 1659910438 | Adam Joseph Mckillip | Physician Assistant | 1304 Franklin Ave, Normal, IL 61761-3558 | 2019-12-27 |
| 1093365678 | Kelsey Elizabeth Shrier | Physician Assistant | 207 Landmark Dr Ste A, Normal, IL 61761-3195 | 2019-09-16 |
| 1801358627 | Nicholas Gurganious | Physician Assistant | 1304 Franklin Ave, Normal, IL 61761-3558 | 2019-04-01 |
| 1770782062 | Shaun Michael Rudicil | Physician Assistant | 2200 Fort Jesse Rd, Suite 250, Normal, IL 61761-6286 | 2007-07-16 |
| 1710024674 | Joseph V Piller | Physician Assistant | 1300 Franklin Ave Ste 210, Normal, IL 61761-3588 | 2007-01-31 |
| 1003994104 | Karen Jane Bandusch Harris | Physician Assistant | 405 Kays Drive, Normal, IL 61761 | 2006-11-02 |
| Find all providers in NORMAL | ||||
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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.