JEROME D ANDERSON (NPI# 1619955986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619955986 |
| Entity Type | Individual |
| Full Name | JEROME D ANDERSON |
| Credential | D.O. |
| Practice Address |
525 E Grant St Macomb IL 61455-3313 |
| Mailing Address |
Po Box 2660 Waterloo IA 50704-2660 |
| Practice Telephone | 3098372368 |
| Practice Fax Number | 3192330722 |
| Mailing Telephone | 3192333044 |
| Mailing Fax Number | 3192330722 |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2007-07-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0101X |
Pathology Specialization: Anatomic Pathology |
36075427 | IL | Allopathic & Osteopathic Physicians |
| N | 207ZP0101X |
Pathology Specialization: Anatomic Pathology |
03039 | IA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023435807 | Jerome Anderson | Social Worker | 1719 Coupru Ct, Saint Peters, MO 63376-4558 | 2014-03-18 |
| 1780981514 | Jerome Keith Anderson | Counselor | 1151 Taylor St Ste 570a, Detroit, MI 48202-1732 | 2011-02-14 |
| 1265436281 | Jerome Lyman Anderson | Internal Medicine | 3433 Nw 56th St, Ste 400, Oklahoma City, OK 73112-4430 | 2005-06-08 |
| Street Address |
525 E GRANT ST |
| City | MACOMB |
| State | IL |
| Zip Code | 61455-3313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356329627 | Richard C Watson | Pathology | 525 E Grant St, Macomb, IL 61455-3313 | 2006-01-05 |
| 1700413481 | Macomb Emergency Physicians LLC | Emergency Medicine | 525 E Grant St, Macomb, IL 61455-3313 | 2020-03-24 |
| 1932748159 | Josie Lee Bauer | Counselor | 525 E Grant St, Macomb, IL 61455-3318 | 2020-01-06 |
| 1215408968 | Ladawna Jo Royer | Nurse Practitioner | 525 E Grant St, Macomb, IL 61455-3313 | 2018-12-06 |
| 1053895953 | Naomi R Polley | Family Medicine | 525 E Grant St, Macomb, IL 61455-3318 | 2018-09-18 |
| 1427534684 | Leah Jean Rybakowski | Counselor | 525 E Grant St, Macomb, IL 61455-3313 | 2018-07-11 |
| 1467954974 | Alissa Sue Fisk | Counselor | 525 E Grant St, Macomb, IL 61455-3313 | 2018-03-01 |
| 1023531142 | Kelsi D Cunningham | Nurse Practitioner | 525 E Grant St, Macomb, IL 61455-3313 | 2017-07-20 |
| 1093268724 | Megan Clemens | Nurse Practitioner | 525 E Grant St, Macomb, IL 61455-3313 | 2016-07-29 |
| 1982050415 | Kaye Stone | Nurse Practitioner | 525 E Grant St, Macomb, IL 61455-3313 | 2016-05-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043869944 | Wesley Village, Inc | Speech-Language Pathologist | 1200 East Grant Street, Macomb, IL 61455 | 2019-09-04 |
| 1780154013 | Hannah Lauren Bengtson | Optometrist | 820 E. Jackson St., Macomb, IL 61455 | 2018-11-29 |
| 1255832564 | Lifeguard Ambulance Service of Illinois Inc. | Ambulance | 219 W Jackson St, Macomb, IL 61455 | 2018-02-22 |
| 1821516816 | Michelle Deann Sargeant | Speech-Language Pathologist | 315 N. Bonham, Macomb, IL 61455 | 2017-08-30 |
| 1972020360 | Kara Marie Wright | Speech-Language Pathologist | 315 N. Bonham St., Macomb, IL 61455 | 2017-08-25 |
| 1720356504 | Dawn M. Kedzior | Social Worker | 103 South Johnson Street, Macomb, IL 61455 | 2011-12-07 |
| 1255632642 | Michael Kurt Sharp | Audiologist | Memorial Hall, Second Floor, W Murray St, Macomb, IL 61455 | 2010-11-16 |
| 1952538704 | Mary L. Smith | Developmental Therapist | 1 University Circle, Western Il Univ, Cntr for Best Practices In Early Childhood Education, Macomb, IL 61455 | 2009-06-19 |
| 1982857827 | Macomb Oncology Institute Ltd | Radiology | 401 East Grant Street, Macomb, IL 61455 | 2008-10-23 |
| 1245488345 | Sonja E Schmidt | Social Worker | 119 Wetzel Hall, Western Illinois University, Macomb, IL 61455 | 2008-09-03 |
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| Taxonomy Code | 207ZP0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. [7/1/2007: definition added, source added, 7/1/2009: defintion reformatted; 7/1/2011: modified source] - Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. American Osteopathic Board of Pathology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology (note: this taxonomy code identifies the "anatomic pathology only" route). To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356329627 | Richard C Watson | Pathology | 525 E Grant St, Macomb, IL 61455-3313 | 2006-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003270588 | Katrina Krogh | Pathology | 251 E Huron St Ste 7-132i, Chicago, IL 60611-2908 | 2016-04-11 |
| 1316334881 | Ryan Dale Jones | Pathology | 430 W Gartner Rd, Naperville, IL 60540-7517 | 2015-04-22 |
| 1568858934 | Haoliang Xu | Pathology | 251 E Huron St Ste 7-332, Chicago, IL 60611-2908 | 2015-04-12 |
| 1821403569 | Elisheva Douglas Shanes | Pathology | 710 N Fairbanks Ct Ste 2-461, Chicago, IL 60611 | 2014-06-20 |
| 1295154052 | Jeffery Adam Goldstein | Pathology | 303 East Chicago Ave, Ward 3-140 W127, Chicago, IL 60611 | 2014-04-09 |
| 1912340589 | Guangyuan Li | Pathology | 251 E Huron St Ste 7-220, Chicago, IL 60611 | 2013-04-12 |
| 1164742722 | Jennifer Ann Bennett | Pathology | 5841 S Maryland Ave # Mc6101, Chicago, IL 60637-1443 | 2010-06-07 |
| 1588853733 | Martin Gross | Pathology | 5841 S Maryland, Mc 3083, Chicago, IL 60637 | 2007-10-23 |
| 1134342900 | Ashok Vasant Shivde | Pathology | 374 Crestwood Rd, Wood Dale, IL 60191-2547 | 2007-04-10 |
| 1245361708 | Anthony V Thomas | Pathology | 1355 N Mittel Blvd, Wood Dale, IL 60191-1024 | 2007-03-08 |
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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.