MRS. KELLSEY R THOLE (NPI# 1407397862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407397862 |
| Entity Type | Individual |
| Full Name | MRS. KELLSEY R THOLE |
| Credential | NP |
| Practice Address |
Three Saint Elizabeth Blvd Ste 2800 O Fallon IL 62269-1282 |
| Practice Telephone | 6182336044 |
| Practice Fax Number | 8339734218 |
| Mailing Telephone | 6182336044 |
| Mailing Fax Number | 8339734218 |
| Enumeration Date | 2017-03-17 |
| Last Update Date | 2020-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
209.015758 | IL | Allopathic & Osteopathic Physicians |
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
209.015758 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
THREE SAINT ELIZABETH BLVD STE 2800 |
| City | O FALLON |
| State | IL |
| Zip Code | 62269-1282 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497754634 | Rebecca Sue Riepshoff | Internal Medicine | Three Saint Elizabeth Blvd Ste 2800, O Fallon, IL 62269-1282 | 2005-07-19 |
| 1982247342 | Christine Walthes | Internal Medicine | Three Saint Elizabeth Blvd Ste 2800, O Fallon, IL 62269-1282 | 2019-10-17 |
| 1497268965 | Dana A Baugher | Internal Medicine | Three Saint Elizabeth Blvd Ste 2800, O Fallon, IL 62269-1282 | 2017-11-07 |
| 1710433768 | Katherine Ann Corbin | Internal Medicine | Three Saint Elizabeth Blvd Ste 2800, O Fallon, IL 62269-1282 | 2016-08-30 |
| 1003166984 | Amanda Monteleone | Internal Medicine | Three Saint Elizabeth Blvd Ste 2800, O Fallon, IL 62269-1282 | 2012-09-18 |
| 1578887063 | Michael J Hushion | Internal Medicine | Three Saint Elizabeth Blvd Ste 2800, O Fallon, IL 62269-1282 | 2010-03-26 |
| 1275799850 | Venkatesh Anjan | Internal Medicine | Three Saint Elizabeth Blvd Ste 2800, O Fallon, IL 62269-1282 | 2008-08-01 |
| 1225295967 | Dana M Loepker | Internal Medicine | Three Saint Elizabeth Blvd Ste 2800, O Fallon, IL 62269-1282 | 2008-05-20 |
| 1407067184 | Shiyam Kumar Satwani | Internal Medicine | Three Saint Elizabeth Blvd Ste 2800, O Fallon, IL 62269-1282 | 2007-05-24 |
| 1861519563 | Pavan Kumar Gupta | Internal Medicine | Three Saint Elizabeth Blvd Ste 2800, O Fallon, IL 62269-1282 | 2007-03-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648155 | Kayla Revermann | Pharmacist | 1350 W Us Highway 50, Pharmacy, O Fallon, IL 62269 | 2020-10-30 |
| 1942814272 | Ashley Monique Gibson | Behavior Technician | Eagle Center, Ste 10, Ofallon, IL 62269 | 2020-09-03 |
| 1013533819 | Michelle Denise Voudrie | Registered Nurse | 321 Regency Park, O'fallon, IL 62269 | 2020-06-18 |
| 1598398455 | Washington University Physicians In Illinois - Cancer Center Pharmacy | Pharmacy | 1418 Cross Street, Suite 180, Shiloh, IL 62269 | 2020-02-19 |
| 1962063800 | Gerald Paskert | Pharmacist | 122 W. State St., O'fallon, IL 62269 | 2019-06-21 |
| 1780144808 | Bonnie Jean Lampe | Physical Therapy Assistant | 316 Donna Dr, O'fallon, IL 62269 | 2019-03-24 |
| 1134633993 | Latisha Smith | Psychologist | 600 S. Smiley St., O'fallon, IL 62269 | 2017-11-30 |
| 1619407210 | Brenna M Thomas | Registered Nurse | 1310 Engle Ct, O'fallon, IL 62269 | 2017-06-15 |
| 1881135622 | Pc Associates, LLC | Family Medicine | 800 East Highway 50, O'fallon, IL 62269 | 2017-03-13 |
| 1700230539 | Jennifer Farrell | Family Medicine | 3 St. Elizabeth's Blvd, Ste. 4000, O'fallon, IL 62269 | 2016-04-18 |
| Find all providers in zip 62269 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437615044 | Ashley M Berneking | Nurse Practitioner | 4122 Keaton Crossing Blvd Ste 102, O Fallon, MO 63368-8219 | 2019-02-19 |
| 1528209319 | Holly M Strassner | Nurse Practitioner | 108 Cloverleaf Meadows Ct, O Fallon, MO 63366-4190 | 2009-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316553472 | Nicholas Johnson | Nurse Practitioner | 8455 S Luella Ave, Chicago, IL 60617-1953 | 2020-09-23 |
| 1710592175 | Mary Maloney | Nurse Practitioner | 348 Westglen Dr, Glen Carbon, IL 62034-1002 | 2020-09-12 |
| 1134738800 | Benjamin Scott Hulfachor | Nurse Practitioner | 4143 N Central Park Ave Apt G, Chicago, IL 60618-2062 | 2020-07-28 |
| 1083222368 | Izolda Rosario | Nurse Practitioner | 501 W Lake St Ste 207, Elmhurst, IL 60126-1419 | 2020-07-22 |
| 1043832785 | Melanie Glander | Nurse Practitioner | 18357 Cowing Ct, Homewood, IL 60430-3332 | 2020-05-16 |
| 1699306902 | Ife Muyiwa-ojo | Nurse Practitioner | 729 E Carpenter St, Springfield, IL 62702-5321 | 2020-01-27 |
| 1962040345 | Doctors Orders Inc. | Nurse Practitioner | 5113 S Harper Ave Ste 2, Chicago, IL 60615-4119 | 2019-12-16 |
| 1801455993 | Parul Arora | Nurse Practitioner | 1717 W Congress Pkwy Ste 1125, Chicago, IL 60612-3809 | 2019-06-11 |
| 1891358222 | Kelly Jo Erke | Nurse Practitioner | 20830 N 1970 East Rd, Danville, IL 61834-6228 | 2019-04-22 |
| 1689136319 | Brittany Sue Borkowski | Nurse Practitioner | 5841 S Maryland Ave # W700, Chicago, IL 60637-1443 | 2019-04-02 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MRS. KELLSEY R THOLE.
| 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.