DR. ALFONSO E URDANETA (NPI# 1225085590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225085590 |
| Entity Type | Individual |
| Full Name | DR. ALFONSO E URDANETA |
| Credential | MD |
| Practice Address |
705 South Grand Avenue Nashville IL 62263-1534 |
| Mailing Address |
3416 Hotze Road Salem IL 62881-6616 |
| Practice Telephone | 6183272225 |
| Practice Fax Number | 6183272229 |
| Mailing Telephone | 6185481185 |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2009-11-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036047128 | IL | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 036047128 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
705 SOUTH GRAND AVENUE |
| City | NASHVILLE |
| State | IL |
| Zip Code | 62263-1534 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730115973 | Mohammed Zahid Siddiqui | Internal Medicine | 705 South Grand Avenue, Nashville, IL 62263-1534 | 2006-06-22 |
| 1770528374 | Andrea Briles | Physician Assistant | 705 South Grand Avenue, Nashville, IL 62263-1534 | 2006-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518407998 | Betty Lou Birchett | Licensed Practical Nurse | 18429 Conservation Drive, Nashville, IL 62263 | 2017-03-03 |
| 1366740219 | Pamela S Lowry | Nurse Practitioner | 705 S. Grand Ave, Nashville, IL 62263 | 2011-03-02 |
| 1639364490 | Donna Trang Nguyen | Dentist | 520 East St Louis Street, Nashville, IL 62263 | 2007-09-13 |
| 1841297413 | Hyet Leslie Settlemoir | Internal Medicine | 705 S Grand St, Nashville, IL 62263 | 2005-06-28 |
| 1114205770 | Jennifer L Pennington | Physical Therapist | 3 Windswept Dr, Nashville, IL 62263 | 2011-08-01 |
| 1144296195 | Rodney Alan Small | Chiropractor | 1527 South Mill Street, Nashville, IL 62263-0027 | 2006-02-28 |
| 1891823662 | Washington County Vocational Workshop | Community/Behavioral Health | 781 E. Holzhauer Dr., Nashville, IL 62263-0273 | 2007-03-01 |
| 1457575243 | Developmental Management, Inc. | Nursing Facility/Intermediate Care Facility | 618 W Goodner St, Nashville, IL 62263-1009 | 2007-04-12 |
| 1144629718 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 618 W Goodner St, Nashville, IL 62263-1009 | 2014-08-19 |
| 1780734293 | County of Washington | Ambulance | 160 N West Court St, Nashville, IL 62263-1128 | 2007-01-10 |
| Find all providers in zip 62263 | ||||
| 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 |
|---|---|---|---|---|
| 1528671294 | Sarah Willms | Family Medicine | 2309 Crestmoor Rd Ste 200, Nashville, TN 37215-2043 | 2020-08-24 |
| 1346861309 | Rx Clinic LLC | Family Medicine | 1046 Mcgavock Pike Ste A, Nashville, TN 37217 | 2020-04-30 |
| 1831728054 | Sanitas Medical Center of Tennessee PC | Family Medicine | 2700 Gallatin Pike Ste A, Nashville, TN 37216-3702 | 2020-04-08 |
| 1851923817 | Tabitha Monique Ford | Family Medicine | 3926 Cross Creek Rd, Nashville, TN 37215-2403 | 2020-02-07 |
| 1235634023 | Jackson Primary Care | Family Medicine | 2010 Church St Ste 526, Nashville, TN 37203 | 2018-03-26 |
| 1942667761 | Harpeth Valley Health Center Pllc | Family Medicine | 213 Old Hickory Blvd, Nashville, TN 37221-1301 | 2016-01-25 |
| 1083001747 | Oyedotun Oyewole | Family Medicine | 1005 Dr D.b. Todd Jr Blvd, Nashville, TN 37208 | 2015-04-21 |
| 1922493576 | Monica A Stout | Family Medicine | 1500 21st Ave S Ste 3000, Nashville, TN 37212-3139 | 2015-03-31 |
| 1700213584 | Music City Medical Pllc | Family Medicine | 417 Welshwood Dr Ste 112, Nashville, TN 37211-4225 | 2013-10-11 |
| 1265869853 | Willie James Myers Jr. | Family Medicine | 2720 Clarksville Pike, Nashville, TN 37208-1259 | 2013-09-27 |
| Find all providers in NASHVILLE | ||||
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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.