ANGELA M PROSISE


Address: 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034
Phone: 2177880706

ANGELA M PROSISE (NPI# 1578647947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1578647947
Entity Type Individual
Full Name ANGELA M PROSISE
Other Name ANGELA M CARR
Credential P.A.
Practice Address 619 E Mason St
Suite 4p57
Springfield
IL 62701-1034
Mailing Address Po Box 19420
Springfield
IL 62794-9420
Practice Telephone 2177880706
Practice Fax Number 2175252535
Mailing Telephone 2177880706
Mailing Fax Number 2175252535
Enumeration Date 2006-10-24
Last Update Date 2012-03-21
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
085-002151 IL Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
IL RAILROAD P00092459 01

Office Location

Street Address 619 E MASON ST
SUITE 4P57
City SPRINGFIELD
State IL
Zip Code 62701-1034

Providers in the same location

NPI Name Taxonomy Address Enumeration
1033190814 Carl E Arentzen Thoracic Surgery (Cardiothoracic Vascular Surgery) 619 E Mason St, Suite 3p25, Springfield, IL 62701-1034 2005-11-09
1669913349 Laura Grubb Internal Medicine 619 E Mason St, Ste. 4p57, Springfield, IL 62701-1034 2017-03-15
1265974604 Julie Borjon Internal Medicine 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 2016-11-16
1912358565 Meleah Vaughan Nurse Practitioner 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 2016-06-24
1508225616 Margaret Jordan Internal Medicine 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 2016-02-17
1487011144 Shauna Vogler Internal Medicine 619 E Mason St, Springfield, IL 62701-1034 2016-01-25
1871987750 Amy Durako Thoracic Surgery (Cardiothoracic Vascular Surgery) 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 2015-03-27
1215333604 Meredith Fleming Internal Medicine 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 2014-11-12
1154623585 Margie Douglas Nurse Practitioner 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 2010-11-17
1326378175 Angela K. Lafrenz Internal Medicine 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 2009-12-29
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1932687183 Affinity Patient Coordination LLC In Home Supportive Care 217 E Monroe St Ste 102, Springfield, IL 62701 2018-07-31
1427498435 Donald L Jacoby Pharmacist 701 N. First St., Springfield, IL 62701 2013-07-05
1700183480 Erin Zepp Dietitian, Registered 319 E Madison St Ste 1f, Springfield, IL 62701 2011-02-16
1518117159 Jyoti Assudani Pediatrics 301 N 8th Street, Springfield, IL 62701 2008-09-19
1396924148 Jeanne Lyn Malone Counselor 408 South Fifth Street, Springfield, IL 62701 2007-10-29
1942422928 Nobuharu Harada Family Medicine 301 N 8th, Pav-3a158, Springfield, IL 62701 2007-05-02
1427131127 Radiological Associates of Decatur Radiology 319 E Madison Suite J, Springfield Mri & Imaging Center, Springfield, IL 62701 2006-10-24
1669498606 Independence Holding Co LLC Pharmacy 201 North 5th Street, Springfield, IL 62701 2006-07-14
1720070238 Neil J. Thomas Thoracic Surgery (Cardiothoracic Vascular Surgery) 619 E Mason St Ste 4p57, Springfield, IL 62701 2005-08-19
1588187397 Andrea Nicole Bloodworth Internal Medicine 619 E Mason St Ste 4p57, Springfield, IL 62701 2017-07-24
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1871122168 Alexandra Emmanuelle Rochman Physician Assistant 54 W Crystal Brook Dr, Springfield, MA 01118-1946 2020-04-07
1740740737 Western New England University Physician Assistant 215 Wilbraham Road, Springfield, MA 01119 2019-03-25
1033462387 Miguel Angel Medina Physician Assistant 1900 South Sunshine Ave., Springfield, MO 65807 2012-10-24
1770850216 Lauren Jennifer Navas Physician Assistant 100 River St Ste 2, Springfield, VT 05156-2930 2011-11-29
1295885168 Jacqueline Kernaghan Physician Assistant 723 Saxer Ave, Springfield, PA 19064-3503 2007-01-11
1295746733 Gwen Wright Physician Assistant 194 W Sproul Rd, Suite 105, Springfield, PA 19064-2027 2006-08-10
1164490710 Stacie L Pierce Physician Assistant 3721 W El Castile St, Springfield, MO 65807-5431 2006-03-09
1245206432 Annette K Bates Physician Assistant 819 Worcester St Ste 3, Springfield, MA 01151-1056 2006-02-27
1518947159 Louis Patrick Favata Physician Assistant 140 High St., Springfield, MA 01199 2006-01-19
1649257031 Scott D Rubin Physician Assistant 3400 Main Street, Springfield, MA 01107-1113 2005-12-27
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Competitor

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City SPRINGFIELD
Zip Code 62701

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Dataset Information

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.

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