NICHOLAS WARNECKE (NPI# 1053563643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053563643 |
| Entity Type | Individual |
| Full Name | NICHOLAS WARNECKE |
| Credential | PA-C |
| Practice Address |
112 Ne Crescent Ave Peoria IL 61606-1901 |
| Mailing Address |
5100 Reliable Pkwy Chicago IL 60686-0001 |
| Practice Telephone | 3096724670 |
| Mailing Telephone | 3096724809 |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2008-10-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085003358 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
112 NE CRESCENT AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61606-1901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265485973 | Heartland Home Health Care Inc. | Prosthetic/Orthotic Supplier | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2006-05-17 |
| 1265070494 | Aaron M Owens | Nurse Practitioner | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2019-12-18 |
| 1881151538 | Heather Franklin | Nurse Practitioner | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2019-02-28 |
| 1558830851 | Courtney D Edsall | Nurse Practitioner | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2018-11-15 |
| 1285142281 | Matthew Culp | Nurse Practitioner | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2018-01-12 |
| 1063936573 | Cheryl Herrmann | Clinical Nurse Specialist | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2017-07-27 |
| 1225566334 | Jodi Nutter | Nurse Practitioner | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2017-06-02 |
| 1063720993 | Pawan Damodhar Sarda | Internal Medicine | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2010-09-14 |
| 1194974964 | Tahir Ilahi | Internal Medicine | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2008-09-16 |
| 1548440803 | Shahid Wazir | Internal Medicine | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2007-11-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194292334 | Kelley Stork | Speech-Language Pathologist | 807 W Columbia Terrace, Peoria, IL 61606 | 2018-10-25 |
| 1689140519 | Emma Cristine Tully | Speech-Language Pathologist | 1619 W. Fredonia Ave, Peoria, IL 61606 | 2018-10-18 |
| 1316492432 | Jennifer Greenwood | Nurse Practitioner | 1001 Main St Ste 500a, Peoria, IL 61606 | 2016-08-18 |
| 1104944974 | Robert I Martin | Preventive Medicine | 1127 N North Street, Peoria, IL 61606 | 2007-03-27 |
| 1023062312 | Saint Francis Medical Center | Physical Medicine & Rehabilitation | 100 Ne Randoph Street, Peoria, IL 61606 | 2006-05-20 |
| 1174573307 | Cpo Services, Inc | Prosthetic/Orthotic Supplier | 741 West Main Street, Peoria, IL 61606 | 2006-05-10 |
| 1174025357 | Amy M Durst | Nurse Practitioner | 1001 Main St Ste 500a, Peoria, IL 61606 | 2018-03-05 |
| 1538471099 | Jacob Royle Hopping | Surgery | 1001 Main St Ste 300, Peoria, IL 61606 | 2010-07-12 |
| 1881906410 | Heather Jefford | Clinical Nurse Specialist | 1001 Main St, 3rd Floor, Peoria, IL 61606 | 2010-07-12 |
| 1306874128 | David L Crawford | Surgery | 1001 Main Street, Suite 300, Peoria, IL 61606 | 2006-06-29 |
| Find all providers in zip 61606 | ||||
| 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 |
|---|---|---|---|---|
| 1275148280 | Patricia Miriam Rus | Physician Assistant | 23615 N 105th Dr, Peoria, AZ 85383-1195 | 2020-09-15 |
| 1083235154 | Katlyn Coyer | Physician Assistant | 900 Main St Ste 530, Peoria, IL 61602-1005 | 2020-04-30 |
| 1114586690 | Courtney A Hitpas | Physician Assistant | 3120 N Bigelow St, Peoria, IL 61604-1628 | 2019-06-10 |
| 1689137671 | Jeffrey Benjamin Miessau | Physician Assistant | 7707 N Knoxville Ave Ste 200, Peoria, IL 61614-2020 | 2019-04-08 |
| 1417413337 | Michelle Nemeh | Physician Assistant | 6760 W Thunderbird Rd Ste 100, Peoria, AZ 85381-5048 | 2019-02-15 |
| 1730655572 | Sylwia M. Budzik | Physician Assistant | 8600 Illinois Rt. 91, Suite 300, Peoria, IL 61615 | 2018-10-19 |
| 1962977538 | Ashley Deyoung | Physician Assistant | 13943 N 91st Ave Ste F101, Peoria, AZ 85381-3689 | 2018-10-09 |
| 1326557141 | Melissa L. Kingston | Physician Assistant | 13760 N 93rd Ave Ste 201, Peoria, AZ 85381-4200 | 2017-09-25 |
| 1396196465 | Ayla Diamond | Physician Assistant | 9165 W Thunderbird Rd Ste 200, Peoria, AZ 85381-4847 | 2016-06-29 |
| 1336530948 | Carolina C. Castro | Physician Assistant | 13128 N. 94th Drive, Suite 100, Peoria, AZ 85381-4252 | 2015-02-18 |
| Find all providers in PEORIA | ||||
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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.