MEMORIAL PHYSICIAN SERVICES (NPI# 1174877930) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174877930 |
Entity Type | Organization |
Organization Name | MEMORIAL PHYSICIAN SERVICES |
Practice Address |
3132 Old Jacksonville Rd Springfield IL 62704-7400 |
Mailing Address |
Po Box 3428 Springfield IL 62708-3428 |
Practice Telephone | 2178620800 |
Practice Fax Number | 2178620871 |
Mailing Telephone | 8005775368 |
Mailing Fax Number | 2177572021 |
Enumeration Date | 2012-11-01 |
Last Update Date | 2020-06-11 |
Authorized Official Name | JAMES T DOWELL (VICE PRESIDENT, MPS) |
Authorized Official Telephone | 2177883342 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
Address | Telephone Number | Fax Number |
---|---|---|
701 N 1st St, Mps, Springfield, IL 627810001 | 8005775368 | 2177572021 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316470651 | Memorial Physician Services | Internal Medicine | 701 N 1st St, Mailbox 95, Springfield, IL 62781-0001 | 2017-04-04 |
1275065906 | Memorial Physician Services | Internal Medicine | 701 N 1st St, Mailbox 95, Springfield, IL 62781-0001 | 2017-03-31 |
1063961936 | Memorial Physician Services | General Acute Care Hospital | 3132 Old Jacksonville Rd, Springfield, IL 62704-7400 | 2016-10-03 |
1205180056 | Memorial Physician Services | Clinic/Center | 1600 W Walnut St, East Wing, 3rd Floor, Jacksonville, IL 62650-1136 | 2012-11-01 |
1104179415 | Memorial Physician Services | Clinic/Center | 1602 W Lafayette Ave, Jacksonville, IL 62650-1007 | 2012-10-24 |
1558614867 | Memorial Physician Services | Clinic/Center | 15 Founders Ln, Suite 100, Jacksonville, IL 62650-3919 | 2012-10-24 |
1881947174 | Memorial Physician Services | Clinic/Center | 1606 W Lafayette Ave, Jacksonville, IL 62650-3707 | 2012-10-24 |
1790038099 | Memorial Physician Services | Clinic/Center | 1 Centre Dr, Petersburg, IL 62675-9467 | 2012-10-24 |
1568715126 | Memorial Physician Services | Clinic/Center | 515 N College St, Lincoln, IL 62656-1401 | 2012-10-19 |
1477614105 | Memorial Physician Services | Clinic/Center | 515 N College St, Lincoln, IL 62656-1401 | 2006-12-13 |
Street Address |
3132 OLD JACKSONVILLE RD |
City | SPRINGFIELD |
State | IL |
Zip Code | 62704-7400 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952308884 | Lorie Ann Bleyer | Internal Medicine | 3132 Old Jacksonville Rd, Suite 200, Springfield, IL 62704-7400 | 2005-07-07 |
1245897255 | Haylie A Damhoff | Nurse Practitioner | 3132 Old Jacksonville Rd, Springfield, IL 62704-7400 | 2019-05-24 |
1285192385 | Katherine M Winner | Nurse Practitioner | 3132 Old Jacksonville Rd, Springfield, IL 62704-7400 | 2019-03-07 |
1861965873 | Kathryn E Carnes | Nurse Practitioner | 3132 Old Jacksonville Rd, Springfield, IL 62704-7400 | 2019-01-03 |
1558830315 | Katlyn Hott | Nurse Practitioner | 3132 Old Jacksonville Rd, Springfield, IL 62704-7400 | 2018-11-21 |
1124501606 | Ashley H Overmeyer | Nurse Practitioner | 3132 Old Jacksonville Rd, Springfield, IL 62704-7400 | 2018-09-11 |
1780175778 | Amber Sperry | Nurse Practitioner | 3132 Old Jacksonville Rd, Springfield, IL 62704 | 2018-05-24 |
1114435559 | Carol J Lantz | Nurse Practitioner | 3132 Old Jacksonville Rd, Springfield, IL 62704 | 2018-01-19 |
1275041097 | Nicole R Johnson | Nurse Practitioner | 3132 Old Jacksonville Rd, Springfield, IL 62704-7400 | 2018-01-15 |
1255843272 | Allison M Trigg | Nurse Practitioner | 3132 Old Jacksonville Rd, Springfield, IL 62704-7400 | 2017-10-31 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902394901 | Hillary Haaker | Occupational Therapist | 2035 W Iles, Suite C, Springfield, ID 62704 | 2018-04-25 |
1871095364 | Edward Doyle Slifer Sr. | Pathology | 2117 Greenside Drive, Spring Field, IL 62704 | 2018-03-01 |
1598263345 | Santarelli & Feller Dental Group | Dentist | 1140 Rickard Road, Suite B, Springfield, IL 62704 | 2018-01-26 |
1447774757 | Lisa Ann Rogers | Developmental Therapist | 2101 Lexington Dr, Apt 3, Springfield, IL 62704 | 2017-07-28 |
1730611286 | Mindi Rowe | Occupational Therapist | 2508 County Rd 4 1/2 E, Springfield, IL 62704 | 2017-04-03 |
1366992208 | Jayme Jordan | Contractor | 2409 Westchester Blvd, Springfield, IL 62704 | 2016-10-04 |
1154793974 | Dina Payne | Social Worker | 917 Clocktower Drive, Suite 600, Springfield, IL 62704 | 2015-10-21 |
1770959819 | James R Reynolds | Hearing Instrument Specialist | 2347 W Monroe St, Springfield, IL 62704 | 2015-08-12 |
1336576495 | Emily Jane Dungey | Counselor | 920 S Spring St Ste 1300, Springfield, IL 62704 | 2013-10-03 |
1942552161 | Jeannie Marie Hundley | Specialist/Technologist, Other | 2921 Monvale Drive, Springfield, IL 62704 | 2012-10-11 |
Find all providers in zip 62704 |
Taxonomy Code | 207Q00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
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1841802592 | Community Health and Wellness Services, Inc. | Family Medicine | 312 Memorial Park Dr, Springfield, PA 19064-1714 | 2020-08-22 |
1649815796 | 180 Health Lifestyle Wellness Centers | Family Medicine | 1936 S Glenstone Ave, Springfield, MO 65804-2305 | 2019-11-13 |
1790337988 | Aminat Ogun | Family Medicine | 520 N 4th St # 62702, Springfield, IL 62702-5238 | 2019-07-09 |
1770076622 | Thomas John Schumann | Family Medicine | 1260 E. Woodlawn Ave, Suite 200, Springfield, PA 19064-3988 | 2018-06-14 |
1134648959 | Patricia Derges | Family Medicine | 3259 E Sunshine St Ste Aa, Springfield, MO 65804-2114 | 2017-09-12 |
1740704667 | Mercy Management of Sepa | Family Medicine | 1001 Baltimore Pike Ste 109, Springfield, PA 19064-2852 | 2017-08-02 |
1083134902 | Trevor Conner | Family Medicine | 1423 N Jefferson Ave, B100, Springfield, MO 65802 | 2017-06-21 |
1790215853 | Vincent Marchese | Family Medicine | 1260 E Woodland Ave Ste 200, Springfield, PA 19064-3956 | 2017-06-12 |
1184152100 | Canaan Arceneaux | Family Medicine | 1001 Baltimore Pike Ste 106, Springfield, PA 19064-2800 | 2017-06-03 |
1063943587 | Cody Stark Rogers | Family Medicine | 1423 N Jefferson Ave # A100, Springfield, MO 65802-1988 | 2017-03-26 |
Find all providers in SPRINGFIELD |
City | SPRINGFIELD |
Zip Code | 62704 |
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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.