HALEY MEDVICK (NPI# 1568774446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568774446 |
| Entity Type | Individual |
| Full Name | HALEY MEDVICK |
| Credential | PA-C |
| Practice Address |
5900 Bond Ave Centreville IL 62207-2326 |
| Practice Telephone | 6183325481 |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2010-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085.003580 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5900 BOND AVE |
| City | CENTREVILLE |
| State | IL |
| Zip Code | 62207-2326 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900763 | Danielle Victoria Williams | Dietitian, Registered | 5900 Bond Ave, Centreville, IL 62207-2326 | 2020-10-22 |
| 1750992459 | Touchette Regional Hospital Inc | Psychiatric Unit | 5900 Bond Ave, Centreville, IL 62207-2326 | 2020-08-14 |
| 1932722295 | Alecia E Marks | Social Worker | 5900 Bond Ave, Centreville, IL 62207-2326 | 2020-05-21 |
| 1194345322 | Lisa Bicket | Social Worker | 5900 Bond Ave, Centreville, IL 62207-2326 | 2020-04-17 |
| 1578034609 | Jennifer Wuerffel | Dietitian, Registered | 5900 Bond Ave, Centreville, IL 62207-2326 | 2018-12-16 |
| 1467922708 | Laura Anne Lengyel | Counselor | 5900 Bond Ave, Centreville, IL 62207-2326 | 2018-11-29 |
| 1053853143 | Touchette Regional Hospital - Transportation | Non-emergency Medical Transport (VAN) | 5900 Bond Ave, Centreville, IL 62207-2326 | 2016-11-07 |
| 1629498266 | Jami Szwargulski | Dietitian, Registered | 5900 Bond Ave, Centreville, IL 62207-2326 | 2014-04-22 |
| 1538449509 | Southern Illinois Healthcare Foundation, Inc | Family Medicine | 5900 Bond Ave, Centreville, IL 62207-2326 | 2011-08-23 |
| 1013208958 | Moungar Elton Cooper | Surgery | 5900 Bond Ave, Centreville, IL 62207-2326 | 2011-04-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114493723 | Monica Marie Magowan | Nurse Practitioner | Touchette Regional Hospital, 5900 Bond Ave, Centreville, IL 62207 | 2018-10-22 |
| 1063708345 | Porshia Lenee' Egerson | Student in an Organized Health Care Education/Training Program | 6032 Clarita Ave, Centreville, IL 62207-1019 | 2011-06-24 |
| 1679742506 | Comprehensive Mental Health Center of St. Clair County, Inc. | Community/Behavioral Health | 1501 S G St, East Saint Louis, IL 62207-2057 | 2008-02-25 |
| 1780853614 | Comprehensive Mental Health Center of St. Clair County, Inc. | Clinic/Center | 1500 Wilford Ave, East Saint Louis, IL 62207-2066 | 2008-02-25 |
| 1891395893 | Cheryl Lynn Eubanks | Technician | 1710 Mccasland Ave, East Saint Louis, IL 62207-2245 | 2020-10-28 |
| 1871086082 | Medicate Pharmacy Inc | Pharmacy | 5869 Bond Ave, Centreville, IL 62207-2300 | 2018-06-12 |
| 1518079243 | Heather L Lucas-foster | Family Medicine | 6010 Bond Ave, Centreville, IL 62207-2328 | 2006-08-31 |
| 1386633295 | Heather Surratt | Dentist | 6000 Bond Ave, Sihf - Mcc, Centreville, IL 62207-2328 | 2005-10-14 |
| 1730574617 | Lara E. Stein | Obstetrics & Gynecology | 6000 Bond Ave, Centreville, IL 62207-2328 | 2015-03-30 |
| 1134546690 | Bhawna Sharma | Psychiatry & Neurology | 6000 Bond Ave, Centreville, IL 62207-2328 | 2014-03-23 |
| Find all providers in zip 62207 | ||||
| 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 |
|---|---|---|---|---|
| 1750992251 | Olivia Rae Wojtowicz | Physician Assistant | 102 Farm Hill Rd, Centreville, MD 21617-2108 | 2020-08-10 |
| 1699089599 | Nell Juliet Bodani | Physician Assistant | 2522 Ruthsburg Rd, Centreville, MD 21617-1952 | 2010-08-03 |
| 1700343951 | Kayla Marie Huber | Physician Assistant | 14001a Saint Germain Dr, Centreville, VA 20121-2338 | 2019-02-25 |
| 1164932141 | Kaylee Laura Perkins | Physician Assistant | 405 Belcher St, Centreville, AL 35042-2946 | 2017-10-04 |
| 1962940544 | Kathleen Rouprich Huff | Physician Assistant | 178 Highway 24 E, Centreville, MS 39631-4171 | 2017-02-03 |
| 1003367541 | Mariah Leigh Butler | Physician Assistant | 405 Belcher St, Centreville, AL 35042-2946 | 2016-10-19 |
| 1205385655 | Chasity Clark | Physician Assistant | 405 Belcher St, Centreville, AL 35042-2946 | 2016-09-27 |
| 1124479829 | Gemini Emergency Physicians, LLC | Physician Assistant | 270 E Main St, Centreville, MS 39631-4200 | 2016-06-24 |
| 1306201736 | Asma Jamil | Physician Assistant | 13890 Braddock Rd, #100, Centreville, VA 20121-2435 | 2015-12-30 |
| 1972980720 | Kenneth A Griffith II | Physician Assistant | 677 E Main St, Centreville, MI 49032-8524 | 2015-04-30 |
| Find all providers in CENTREVILLE | ||||
| City | CENTREVILLE |
| Zip Code | 62207 |
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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.