MS. MALLORY JEAN STIMAC (NPI# 1043856701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043856701 |
| Entity Type | Individual |
| Full Name | MS. MALLORY JEAN STIMAC |
| Credential | PA |
| Practice Address |
6800 State Route 162 Maryville IL 62062-8521 |
| Mailing Address |
200 Corporate Blvd Lafayette LA 70508-3870 |
| Practice Telephone | 6182885711 |
| Practice Fax Number | 6182884088 |
| Mailing Telephone | 8008939698 |
| Enumeration Date | 2019-11-18 |
| Last Update Date | 2019-11-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085007315 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6800 STATE ROUTE 162 |
| City | MARYVILLE |
| State | IL |
| Zip Code | 62062-8521 |
| 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 |
| 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 |
| 1356821383 | Natalie Ann Ritzheimer | Physician Assistant | 6800 State Route 162, Maryville, IL 62062-8521 | 2018-08-20 |
| 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 | 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 |
|---|---|---|---|---|
| 1295298081 | Corinne S Murphy | Physician Assistant | 6800 State Route 162 # 215, Maryville, IL 62062-8500 | 2019-04-09 |
| 1104325091 | Jennifer M Oyler | Physician Assistant | 6812 State Route 162 Suite 120, Maryville, IL 62062 | 2018-02-06 |
| 1053796227 | Hillary Lynn Tipton | Physician Assistant | 2081 Colonial Cir, Maryville, TN 37803-2678 | 2015-07-29 |
| 1871905794 | Best Weigh Weight Loss Center LLC | Physician Assistant | 1805 W Broadway Ave, Maryville, TN 37801-5511 | 2014-05-27 |
| 1891092474 | Kimberly M Schneider | Physician Assistant | 20b Professional Park Drive, Maryville, IL 62062 | 2011-02-17 |
| 1487284360 | Rachel Hannah West | Physician Assistant | 827 E Lamar Alexander Pkwy, Maryville, TN 37804-5001 | 2020-01-20 |
| 1356900492 | Amanda Margaret Altgilbers | Physician Assistant | 6812 State Route 162 Ste 120, Maryville, IL 62062-8586 | 2019-06-12 |
| 1528523719 | Amy Elizabeth Keenan | Physician Assistant | 701 Morganton Square Dr, Maryville, TN 37801-4796 | 2019-02-01 |
| 1891268355 | Eric Michael Watson | Physician Assistant | 6800 State Route 162, Maryville, IL 62062-8521 | 2019-01-08 |
| 1508331455 | Anna Grace Wooten | Physician Assistant | 250 Bmh Physicians Office Bldg, Maryville, TN 37804 | 2018-10-08 |
| Find all providers in MARYVILLE | ||||
Please comment or provide details below to improve the information on MS. MALLORY JEAN STIMAC.
| 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.