STEPHANIE NICOLE BLAHA (NPI# 1366054116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366054116 |
| Entity Type | Individual |
| Full Name | STEPHANIE NICOLE BLAHA |
| Credential | PA-C |
| Practice Address |
2300 N Edward St Decatur IL 62526-4163 |
| Practice Telephone | 2178768121 |
| Enumeration Date | 2020-08-21 |
| Last Update Date | 2020-11-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085.007939 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 5115-23 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2300 N EDWARD ST |
| City | DECATUR |
| State | IL |
| Zip Code | 62526-4163 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104829886 | Tansel Turgut | Internal Medicine | 2300 N Edward St, Ste 2400, Decatur, IL 62526-4163 | 2005-05-24 |
| 1215538004 | Jordanna Ruth Wilton | Nurse Practitioner | 2300 N Edward St, Decatur, IL 62526-4192 | 2020-11-06 |
| 1861028193 | Angelina Marie Thomas | Nurse Anesthetist, Certified Registered | 2300 N Edward St, Decatur, IL 62526-4163 | 2020-03-18 |
| 1114550944 | Chelsey M Clark | Nurse Anesthetist, Certified Registered | 2300 N Edward St, Decatur, IL 62526-4163 | 2020-02-20 |
| 1942857735 | Jessica Oranika | Nurse Practitioner | 2300 N Edward St, Decatur, IL 62526-4163 | 2019-08-26 |
| 1003463225 | Jason Grauer | Nurse Practitioner | 2300 N Edward St, Decatur, IL 62526-4192 | 2019-08-22 |
| 1780239434 | Maggie Kaye Matthews | Nurse Practitioner | 2300 N Edward St, Decatur, IL 62526-4163 | 2019-08-08 |
| 1871052522 | Michelle Caroline Kronmiller | Nurse Practitioner | 2300 N Edward St, Decatur, IL 62526-4163 | 2019-03-12 |
| 1013474097 | Brittney L Jeffery | Nurse Anesthetist, Certified Registered | 2300 N Edward St, Decatur, IL 62526-4163 | 2019-02-26 |
| 1164988325 | Brandon Barringer | Pharmacist | 2300 N Edward St, Decatur, IL 62526-4163 | 2019-02-13 |
| Find all providers in the same location | ||||
| 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 | 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 |
|---|---|---|---|---|
| 1598374860 | Lauren Nolan | Physician Assistant | 500 Irvin Ct # 200, Decatur, GA 30030-1705 | 2020-07-23 |
| 1134749930 | Elissa Stanton | Physician Assistant | 1280 Sanden Ferry Dr, Decatur, GA 30033-3346 | 2020-04-21 |
| 1902457138 | April Lynette Williams | Physician Assistant | 3669 Riverchase Ter, Decatur, GA 30034-4876 | 2019-09-29 |
| 1194389353 | Katherine Serafen | Physician Assistant | 2701 N Decatur Road, Ground Floor Suite 520, Decatur, GA 30033 | 2019-04-23 |
| 1124531249 | Carolina Espina | Physician Assistant | 2665 N Decatur Rd Ste 630, Decatur, GA 30033-6147 | 2017-11-10 |
| 1447703731 | Jessica Lin Brewer | Physician Assistant | 2186 Clairmont Rd, Decatur, GA 30033-1937 | 2016-08-03 |
| 1174972459 | Peter Bell | Physician Assistant | 2946 Clifton Springs Rd, Decatur, GA 30034-3820 | 2016-06-08 |
| 1902299597 | Farida Ahmadi | Physician Assistant | 200 E Ponce De Leon Ave Ste 110, Decatur, GA 30030-3467 | 2015-03-06 |
| 1730431313 | Daniel Lau | Physician Assistant | 2801 N. Decatur Road Suite 200, Decatur, GA 30033 | 2012-10-08 |
| 1720344302 | Kanwal Kapadia Lalani | Physician Assistant | 2665 N Decatur Rd Ste 430, Decatur, GA 30033-6145 | 2012-04-08 |
| 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.