ANDREW ROUDEBUSH (NPI# 1376540559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1376540559 |
Entity Type | Individual |
Full Name | ANDREW ROUDEBUSH |
Credential | D.O. |
Practice Address |
210 W Walnut St Canton IL 61520-2444 |
Practice Telephone | 3096470201 |
Practice Fax Number | 3096496869 |
Mailing Telephone | 3096470201 |
Mailing Fax Number | 3096496869 |
Enumeration Date | 2005-07-04 |
Last Update Date | 2016-12-26 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Q00000X | Family Medicine | 110832 | MO | Allopathic & Osteopathic Physicians |
Street Address |
210 W WALNUT ST |
City | CANTON |
State | IL |
Zip Code | 61520-2444 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063046464 | Dara Marie Wagner | Nurse Practitioner | 210 W Walnut St, Canton, IL 61520-2444 | 2020-02-25 |
1235699893 | Christina Willey | Occupational Therapist | 210 W Walnut St, Canton, IL 61520-2444 | 2019-03-20 |
1487174744 | Joshua J Wilkinson | Nurse Practitioner | 210 W Walnut St, Canton, IL 61520-2444 | 2017-06-27 |
1124482252 | Ryan Deushane | Nurse Anesthetist, Certified Registered | 210 W Walnut St, Canton, IL 61520 | 2016-04-05 |
1790143683 | Midwest Mobile Anesthesia Consultants, Sc | Nurse Anesthetist, Certified Registered | 210 W Walnut St, Canton, IL 61520-2444 | 2016-02-05 |
1750749826 | Shawn Michael Wynn | Nurse Anesthetist, Certified Registered | 210 W Walnut St, Canton, IL 61520 | 2016-02-04 |
1417312232 | Danielle Marianna Sausaman | Dietitian, Registered | 210 W Walnut St, Graham Hospital Food and Nutrition Services, Canton, IL 61520 | 2015-12-21 |
1932530938 | Amy Sammis | Dietitian, Registered | 210 W Walnut St, Canton, IL 61520-2444 | 2013-12-02 |
1609111988 | William Severt | Physical Therapist | 210 W Walnut St, Canton, IL 61520-2444 | 2012-11-28 |
1437448578 | Sandra Anne Haws | Dietitian, Registered | 210 W Walnut St, Canton, IL 61520-2444 | 2011-03-29 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497978480 | Walton Cs-xi P.C. | Chiropractor | 410 E. Elm Street, Canton, IL 61520 | 2007-04-10 |
1811912918 | Jennifer Christine Daniel-price | Chiropractor | 410 E Elm Street, Canton, IL 61520 | 2006-07-12 |
1245216241 | Fulton County Health Department | Clinic/Center | 700 East Oak Street, Canton, IL 61520 | 2005-12-21 |
1740533835 | Abby L. Sherwood | Chiropractor | 410 E Elm Street, Canton, IL 61520 | 2012-10-26 |
1417261041 | Erin Kathleen Buckley | Obstetrics & Gynecology | 180 S Main St, Canton, IL 61520 | 2010-08-06 |
1619375532 | Brittany Nicole Miller | Nurse Practitioner | 1300 E Locust St, Canton, IL 61520-0008 | 2014-12-09 |
1437197845 | Heartland of Canton Il LLC | Clinic/Center | 2081 N Main St, Canton, IL 61520-1032 | 2006-06-04 |
1568063428 | Mary J Eberle | Pharmacist | 2071 N Main St, Canton, IL 61520-1032 | 2020-11-05 |
1659970267 | Amanda Sue Kinne | Pharmacist | 2071 N Main St, Canton, IL 61520-1032 | 2020-10-23 |
1952879132 | Loft Rehabilitation and Nursing of Canton LLC | Skilled Nursing Facility | 2081 N Main St, Canton, IL 61520-1032 | 2018-11-06 |
Find all providers in zip 61520 |
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. |
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1417571142 | K Loor Medical LLC | Family Medicine | 1750 Marietta Hwy Ste 250, Canton, GA 30114-8388 | 2020-05-28 |
1336762913 | Favor Family Medical Practice | Family Medicine | 103 Mountain Brook Dr Ste 100, Canton, GA 30115-9078 | 2020-05-18 |
1679051213 | Edward Arthur Hill | Family Medicine | 6104 Cedar Lane Nw, Canton, OH 44708 | 2018-08-06 |
1073012118 | Mea Primary Care Plus LLC | Family Medicine | 112 Southlake Cir, Canton, MS 39046-5368 | 2018-02-05 |
1629592175 | Healthy U Academy, LLC | Family Medicine | 1226 Market Ave N, Canton, OH 44714-2604 | 2017-07-26 |
1629508114 | Zeinab M Makki | Family Medicine | 7330 N Canton Center Rd Ste 111, Canton, MI 48187-1538 | 2017-06-15 |
1366805210 | Michael Wowk | Family Medicine | 1600 S Canton Center Rd Ste 220, Canton, MI 48188-6276 | 2016-03-29 |
1184036832 | Courtney Weaver | Family Medicine | 15 Reinhardt College Pkwy Ste 100, Canton, GA 30114-5259 | 2014-05-29 |
Find all providers in CANTON |
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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.