ADVANCED SURGICAL TECHNOLOGY, LLC (NPI# 1497159024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497159024 |
| Entity Type | Organization |
| Organization Name | ADVANCED SURGICAL TECHNOLOGY, LLC |
| Practice Address |
4200 Williamson Pl Ste 1a Mount Vernon IL 62864-6705 |
| Practice Telephone | 6188999200 |
| Practice Fax Number | 6188999206 |
| Mailing Telephone | 6188999200 |
| Mailing Fax Number | 6188999206 |
| Enumeration Date | 2014-10-10 |
| Last Update Date | 2019-07-17 |
| Authorized Official Name | SANDRA L ADAMS (OFFICE ADMINISTRATOR) |
| Authorized Official Telephone | 6189698317 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 036115674 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
4200 WILLIAMSON PL STE 1A |
| City | MOUNT VERNON |
| State | IL |
| Zip Code | 62864-6705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972548287 | Udaya K Liyanage | Surgery | 4200 Williamson Pl Ste 1a, Mount Vernon, IL 62864-6705 | 2006-06-19 |
| 1912528126 | Macey Gettinger | Nurse Practitioner | 4200 Williamson Pl Ste 1a, Mount Vernon, IL 62864-6705 | 2020-04-28 |
| 1104287598 | Abbey Gettinger | Nurse Practitioner | 4200 Williamson Pl Ste 1a, Mount Vernon, IL 62864-6705 | 2016-03-11 |
| 1225367121 | Josh Bruce Knolhoff | Surgery | 4200 Williamson Pl Ste 1a, Mount Vernon, IL 62864-6705 | 2009-12-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619438892 | Melissa Pryer | Dietitian, Registered | 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 | 2019-03-28 |
| 1487145454 | Chiropractic Wellness Center of Mt Vernon, LLC. | Chiropractor | 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 | 2018-05-24 |
| 1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
| 1871907790 | University Hematology Oncology Inc | Specialist | #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 | 2014-06-18 |
| 1457771677 | Dynamic Counseling and Consultation Services | Social Worker | 3600 S Water Tower Pl, Mt Vernon, IL 62864 | 2014-04-27 |
| 1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
| 1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
| 1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
| 1780978627 | Jamie M Orange | Physical Therapy Assistant | 19958 Fairfield Rd, Mt. Vernon, IL 62864 | 2011-06-08 |
| 1780978791 | Wendy Marie Claytor | Speech-Language Pathologist | 600 E Il Hwy 15, Mount Vernon, IL 62864 | 2011-06-07 |
| Find all providers in zip 62864 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679194468 | Sowmya Sreekanth | Surgery | 124 Hutchinson Blvd, Mount Vernon, NY 10552-2510 | 2020-05-03 |
| 1881031144 | Danilo Achy Martins | Surgery | 5 Good Samaritan Way Ste 235, Mount Vernon, IL 62864-2402 | 2013-05-28 |
| 1205936101 | Mount Vernon Surgical Care Inc. | Surgery | 100 E Gambier St, Mount Vernon, OH 43050-3510 | 2006-09-22 |
| 1437256732 | Chen Hu | Surgery | 333 Gramatan Ave, Mount Vernon, NY 10552-3230 | 2006-09-20 |
| 1972548287 | Udaya K Liyanage | Surgery | 4200 Williamson Pl Ste 1a, Mount Vernon, IL 62864-6705 | 2006-06-19 |
| 1144226085 | Kevin B Claffey | Surgery | 4218 Lincolnshire Dr, Mount Vernon, IL 62864-2156 | 2005-06-24 |
| 1467457291 | Paul A Taiganides | Surgery | 1451 Yauger Road, Ste 2a, Mount Vernon, OH 43050 | 2005-06-17 |
| 1790045417 | Patricia Teschke | Surgery | 2 Good Samaritan Way Ste 235, Mount Vernon, IL 62864-2476 | 2012-05-29 |
| 1457675498 | Janice Hyungun Kang | Surgery | 1400 E Kincaid St, Mount Vernon, WA 98274-4127 | 2010-03-19 |
| 1225367121 | Josh Bruce Knolhoff | Surgery | 4200 Williamson Pl Ste 1a, Mount Vernon, IL 62864-6705 | 2009-12-24 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 62864 |
Please comment or provide details below to improve the information on ADVANCED SURGICAL TECHNOLOGY, LLC.
| 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.