STATEN FAMILY PRACTICE PLLC (NPI# 1407474083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407474083 |
| Entity Type | Organization |
| Organization Name | STATEN FAMILY PRACTICE PLLC |
| Practice Address |
500 W Virginia Ave Gillespie IL 62033-1025 |
| Practice Telephone | 2178515270 |
| Mailing Telephone | 2178515270 |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2020-07-09 |
| Authorized Official Name | ROSEMARY STATEN (APRN) |
| Authorized Official Telephone | 2178515270 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Staten Family Practice PLLC | Other Name - Individual/Organization |
| Street Address |
500 W VIRGINIA AVE |
| City | GILLESPIE |
| State | IL |
| Zip Code | 62033-1025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225596950 | Laura Michelle Halpin | Physical Therapist | 607 Litchfield Road, Gillespie, IL 62033 | 2019-03-12 |
| 1770942716 | Carol Candler | Nurse Practitioner | 109 East Maple Street, Maucoupin County Maple Street Clinic, Gillespie, IL 62033 | 2016-02-18 |
| 1932519618 | Terry Allan | Pharmacist | 113 South Macoupin Street, Gillespie, IL 62033 | 2014-05-02 |
| 1649414558 | Bernadette Kathlene Sobczak | Nurse Practitioner | 807 Broadway, Gillespie, IL 62033 | 2009-04-22 |
| 1376765206 | Sheri Lynne Banovic | Nurse Practitioner | 115 South Macoupin Street, Gillespie, IL 62033 | 2007-05-02 |
| 1215044920 | James Paul Verton | Pharmacist | 120 S Macoupin, Dippold Drug Co Inc, Gillespie, IL 62033 | 2006-08-25 |
| 1427575612 | Beth Lynn Sies | Speech-Language Pathologist | 340 Kelly St, Gillespie, IL 62033 | 2017-08-28 |
| 1356599971 | Julia Terese Ruckman | Social Worker | 109 E Maple St, Gillespie, IL 62033 | 2008-09-08 |
| 1124135835 | Bruce W Hughes | Pharmacist | 120 S Macoupin, Dippold Drug Co Inc, Gillespie, IL 62033 | 2006-08-25 |
| 1396244612 | Carlinville Area Hospital Assn | Clinic/Center | 807 Broadway, Gillespie, IL 62033-1100 | 2018-02-02 |
| Find all providers in zip 62033 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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| 1639787823 | Md Infusions, Pllc | Clinic/Center | 666 Dundee Rd Ste 1800, Northbrook, IL 60062-2727 | 2020-07-14 |
| 1629696679 | Serenity Internal Medicine & Wellness Center | Clinic/Center | 3330 W 177th St # 2d-1, Hazel Crest, IL 60429-2184 | 2020-07-07 |
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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.