ANDERSON AND ODUNSI, MD LLC (NPI# 1346399391) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346399391 |
| Entity Type | Organization |
| Organization Name | ANDERSON AND ODUNSI, MD LLC |
| Practice Address |
2 Memorial Dr Suite 305 Decatur IL 62526-3950 |
| Practice Telephone | 2178768370 |
| Practice Fax Number | 2178768375 |
| Mailing Telephone | 2178768370 |
| Mailing Fax Number | 2178768375 |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2012-08-07 |
| Authorized Official Name | DR. ANGELA K. ANDERSON (MEDICAL DOCTOR OB-GYN) |
| Authorized Official Telephone | 2178768370 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
209000428 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | 209001529 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 207V00000X | Obstetrics & Gynecology | 036069886 | IL | Allopathic & Osteopathic Physicians |
| Y | 207V00000X | Obstetrics & Gynecology | 036094384 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD GR | 05832021 | 01 |
| IL | MEDICARE RAILROAD | DA0763 | 01 |
| Street Address |
2 MEMORIAL DR SUITE 305 |
| City | DECATUR |
| State | IL |
| Zip Code | 62526-3950 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508915570 | Joyce Heath | Nurse Practitioner | 2 Memorial Dr, Suite 305, Decatur, IL 62526-3950 | 2007-01-09 |
| 1326058447 | Samuel E. Potts | Podiatrist | 2 Memorial Dr, Suite 201, Decatur, IL 62526-3950 | 2006-08-09 |
| 1962469734 | Robert R Kraus Jr. | Neurological Surgery | 2 Memorial Dr, Ste 207, Decatur, IL 62526-3950 | 2006-04-27 |
| 1306802608 | Decatur Digestive Disease Center LLC | Nurse Anesthetist, Certified Registered | 2 Memorial Dr, Suite 102 Pysician Plaza West, Decatur, IL 62526-3950 | 2006-04-25 |
| 1205892478 | Howard Earl Beede | Allergy & Immunology | 2 Memorial Dr, Suite 204, Decatur, IL 62526-3950 | 2006-04-25 |
| 1508822701 | Oliver N Dold | Neurological Surgery | 2 Memorial Dr, Ste 207, Decatur, IL 62526-3950 | 2006-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083100804 | Coalition | Non-emergency Medical Transport (VAN) | 2375 N Longwood Dr, Decatur, IL 62526 | 2018-07-04 |
| 1881116820 | Bria N Howard | Nurse's Aide | 606 E Warren St. Apt 609, Decatur, IL 62526 | 2017-07-12 |
| 1437683679 | Lutheran Child and Family Services | Foster Care Agency | 2826 N. Monroe Street, Decatur, IL 62526 | 2017-04-14 |
| 1083166326 | Whitney Miller | Pharmacist | 225 East Ash Ave, Decatur, IL 62526 | 2016-11-03 |
| 1487053369 | Central Illinois Health Associates, Inc | Preferred Provider Organization | 2300 N. Edward Street, Decatur, IL 62526 | 2014-08-18 |
| 1659787893 | Stephanie Marie Kanitsch | Obstetrics & Gynecology | 544 W Pershing Rd Ste A, Decatur, IL 62526 | 2014-07-09 |
| 1497169973 | Brian Hassinger | Audiologist-Hearing Aid Fitter | 2605 N Water St Ste 101, Decatur, IL 62526 | 2014-06-12 |
| 1891041570 | Decatur 2016 LLC | Dentist | 141 Epershing Rd, Decatur, IL 62526 | 2012-07-31 |
| 1558639005 | Larry Lee Christensen | Pharmacist | 225 Ash Ave, Decatur, IL 62526 | 2011-12-12 |
| 1174821540 | Nathan Pyle | Internal Medicine | 2 Memorial Dr Ste 101, Decatur, IL 62526 | 2011-03-08 |
| Find all providers in zip 62526 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770957177 | Xochitl Dupre | Obstetrics & Gynecology | 1874 Beltline Road Sw, Suite 105, Decatur, AL 35601 | 2015-11-23 |
| 1386038214 | Elise Rebecca Clem | Obstetrics & Gynecology | 1874 Beltline Rd Sw Ste 105, Decatur, AL 35601-5514 | 2015-03-28 |
| 1659787893 | Stephanie Marie Kanitsch | Obstetrics & Gynecology | 544 W Pershing Rd Ste A, Decatur, IL 62526 | 2014-07-09 |
| 1336408830 | Mishanta Reyes | Obstetrics & Gynecology | 1215 7th St Se Fl 2, Decatur, AL 35601 | 2012-05-04 |
| 1295027753 | Georgia Center for Female Health LLC | Obstetrics & Gynecology | 3660 Flat Shoals Pkwy Ste 180, Decatur, GA 30034-1632 | 2011-05-03 |
| 1316258056 | Sarah E. Winter | Obstetrics & Gynecology | 544 W Pershing Rd Ste 200, Decatur, IL 62526 | 2010-06-28 |
| 1790916591 | Philip C Lynch | Obstetrics & Gynecology | 867 W Harper Ave, Decatur, IL 62526-3918 | 2009-07-28 |
| 1972744084 | Decatur General Hospital | Obstetrics & Gynecology | 1107 14th Avenue Se, Suite 320, Decatur, AL 35601 | 2009-03-19 |
| 1255583324 | Decatur General Hospital | Obstetrics & Gynecology | 1202 13th Aveneue Se, Decatur, AL 35601 | 2008-10-21 |
| 1851559983 | Amy Marie Rodatus | Obstetrics & Gynecology | 2801 N Decatur Rd Ste 190, Decatur, GA 30033-5924 | 2008-05-27 |
| Find all providers in DECATUR | ||||
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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.