JODI L BANGERT (NPI# 1518244714) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518244714 |
| Entity Type | Individual |
| Full Name | JODI L BANGERT |
| Credential | PA |
| Practice Address |
900 N 1st St Springfield IL 62702-3749 |
| Mailing Address |
1025 S 6th St Springfield IL 62703-2403 |
| Practice Telephone | 2175287541 |
| Practice Fax Number | 2175353665 |
| Mailing Telephone | 2175287541 |
| Enumeration Date | 2011-11-16 |
| Last Update Date | 2020-05-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085004131 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
900 N 1ST ST |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-3749 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114920139 | Mary Beth Ditman | Nurse Practitioner | 900 N 1st St, Springfield, IL 62702-3749 | 2005-05-23 |
| 1013536804 | Amy N Mann | Nurse Practitioner | 900 N 1st St, Springfield, IL 62702-3749 | 2020-04-11 |
| 1295217727 | Michelle Lee Mccoy | Registered Nurse | 900 N 1st St, Springfield, IL 62702-3749 | 2018-08-31 |
| 1538640941 | Samantha E. Dunkirk | Nurse Practitioner | 900 N 1st St, Springfield, IL 62702-3749 | 2018-08-23 |
| 1376037168 | Stephanie M. Ritter | Registered Nurse | 900 N 1st St, Springfield, IL 62702-3749 | 2018-06-15 |
| 1396237376 | Jennifer L. Johnson | Registered Nurse | 900 N 1st St, Springfield, IL 62702-3749 | 2018-06-05 |
| 1265800163 | Josiah Hamilton | Physician Assistant | 900 N 1st St, Springfield, IL 62702-3749 | 2015-09-09 |
| 1700268216 | Lyndsey Heise | Internal Medicine | 900 N 1st St, Springfield, IL 62702-3749 | 2015-06-19 |
| 1689081861 | Todd Diebold | Obstetrics & Gynecology | 900 N 1st St, Springfield, IL 62702-3749 | 2014-07-19 |
| 1629418454 | Kara Lynn Mccoy | Obstetrics & Gynecology | 900 N 1st St, Springfield, IL 62702-3749 | 2013-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| 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 |
|---|---|---|---|---|
| 1972123289 | Jared Anthony Dias | Physician Assistant | 52 Devens St, Springfield, MA 01151-2304 | 2020-04-16 |
| 1659990976 | Maham Siddiqui | Physician Assistant | 8632 Hillside Manor Dr, Springfield, VA 22152-2238 | 2020-04-16 |
| 1558994772 | Kayla Rice | Physician Assistant | 3640 Main St Ste 103, Springfield, MA 01107-1139 | 2020-02-17 |
| 1487286563 | Michayla Marcil | Physician Assistant | 280 Chestnut St Fl 2, Springfield, MA 01199-1001 | 2020-02-06 |
| 1508416140 | Chase Michael Collings | Physician Assistant | 960 N 16th St Ste 303, Springfield, OR 97477 | 2019-09-16 |
| 1023670593 | Michael Peter Lembotesis | Physician Assistant | 629 Evans Rd, Springfield, PA 19064-3033 | 2019-07-03 |
| 1245795558 | Alexandra Marie Cutler | Physician Assistant | 1437 S Gelven Ave, Springfield, MO 65804-2124 | 2019-01-31 |
| 1598265894 | Kelsey L. Magill | Physician Assistant | 3231 S National Ave Ste 440, Springfield, MO 65807-7304 | 2018-02-14 |
| 1447759592 | Darrell Dewain Edwards | Physician Assistant | 4350 S National Ave Ste C200, Springfield, MO 65810-2782 | 2018-02-05 |
| 1164930087 | Ashley Jean Nichole Leutze | Physician Assistant | 1164 E Home Rd Ste J, Springfield, OH 45503-2726 | 2018-01-12 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
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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.