OB PRACTICE, LLC (NPI# 1629386586) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629386586 |
| Entity Type | Organization |
| Organization Name | OB PRACTICE, LLC |
| Practice Address |
4600 Memorial Drive Ste. 400 Belleville IL 62226 |
| Mailing Address |
4500 Memorial Dr Medical Affairs Credentialing Department Belleville IL 62226-5360 |
| Practice Telephone | 6182342390 |
| Practice Fax Number | 6182349936 |
| Mailing Telephone | (618) 257-4644 |
| Mailing Fax Number | 6182576946 |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | JAMES B. DAVIS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6182574644 |
| Is Organization Subpart | Y |
| Parent Organization Name | OB PRACTICE, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
Allopathic & Osteopathic Physicians | ||
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4600 Memorial Dr Ste 240, Belleville, IL 622265363 | 6182342390 | 6182349936 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437672771 | Ob Practice, LLC | Obstetrics & Gynecology | 1414 Cross St Ste 240, Shiloh, IL 62269-2988 | 2017-07-19 |
| 1770946204 | Ob Practice, LLC | Obstetrics & Gynecology | 1404 Cross St, Third Floor Suite 3181, Shiloh, IL 62269-2988 | 2016-04-01 |
| Street Address |
4600 MEMORIAL DRIVE STE. 400 |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013901487 | Pc Associates,llc | Family Medicine | 4600 Memorial Drive, Ste. 220, Belleville, IL 62226 | 2005-08-31 |
| 1356632186 | Ca Group, LLC | Internal Medicine | 4600 Memorial Drive, Suite W-1, Belleville, IL 62226 | 2011-04-27 |
| 1689997280 | Ca Group LLC | Internal Medicine | 4600 Memorial Drive, Ste. W-1, Belleville, IL 62226 | 2010-03-10 |
| 1265608251 | Renee Lynne Davis | Nurse Practitioner | 4600 Memorial Drive, Suite G60, Belleville, IL 62226-5366 | 2008-04-30 |
| 1407021504 | Valerie J Griffin | Nurse Practitioner | 4600 Memorial Drive, Suite G60, Belleville, IL 62226-5366 | 2008-04-29 |
| 1588704613 | Orthopedic and Sports Medicine Physicians, Ltd | Specialist | 4600 Memorial Drive, Suite 200, Belleville, IL 62226 | 2007-02-07 |
| 1205905197 | Khai Ngo | Pediatrics | 4600 Memorial Drive, Suite 280, Belleville, IL 62276-5366 | 2006-11-07 |
| 1508953746 | Southern Illinois Physician Services, PC | Obstetrics & Gynecology | 4600 Memorial Drive, Suite 340, Belleville, IL 62226 | 2006-10-09 |
| 1376630103 | Southern Illinois Internal Medicine Ltd | Internal Medicine | 4600 Memorial Drive, Suite 310, Belleville, IL 62226-5366 | 2006-10-05 |
| 1306871660 | David Craig Norman | Pediatrics | 4600 Memorial Drive, Medical Office Center #2 Suite G60, Belleville, IL 62226-5366 | 2006-07-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1053969790 | Consistent Medical Transportation | Driver | 2012 N 17th St, Swansea, IL 62226 | 2019-08-27 |
| 1497314371 | Medi-plex Hospice of Illinois, LLC | Registered Nurse | 8 Park Place, Suite #3, Swansea, IL 62226 | 2019-06-13 |
| 1336617364 | Nicole Renee Schmidt | Speech-Language Pathologist | 150 N 27th St., Belleville, IL 62226 | 2018-11-07 |
| 1295258903 | Catherine Espino | Pharmacist | 11 Chambers Blvd, Swansea, IL 62226 | 2017-07-25 |
| 1366806838 | Kiley Faires | Nurse Practitioner | 4600 Memorial Drive Ste 360, Belleville, IL 62226 | 2016-04-11 |
| 1760857585 | Mvp Transportation | Non-emergency Medical Transport (VAN) | 1229 N 17th Street, Number 23, Belleville, IL 62226 | 2015-12-04 |
| 1275952566 | Aisha Danyale Franklin | Internal Medicine | 4261 Woodfield Pl, Belleville, IL 62226 | 2014-04-15 |
| 1396168332 | Jayne E. Ninness | Physical Therapy Assistant | 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 | 2014-01-28 |
| 1053758193 | Gateway Foundation, Inc. | Clinic/Center | 1 Bronze Point, Suite 1, Swansea, IL 62226 | 2013-05-30 |
| Find all providers in zip 62226 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144663568 | Katy Elizabeth Gray | Obstetrics & Gynecology | 4600 Memorial Dr Ste 240, Belleville, IL 62226-5363 | 2013-04-16 |
| 1083942635 | Mohamed A Esiely | Obstetrics & Gynecology | 82 Van Houten Pl, Belleville, NJ 07109-2543 | 2009-11-19 |
| 1912045287 | Women's Care Nj Pa | Obstetrics & Gynecology | 36 Newark Ave Ste 128, Belleville, NJ 07109-4120 | 2007-02-01 |
| 1023186079 | Women's Healthcare Specialists, P.C. | Obstetrics & Gynecology | 4600 Memorial Dr Ste 400, Medical Office Center Two, Belleville, IL 62226-5366 | 2006-11-30 |
| 1174625313 | Michael E Herrmann Md Ltd | Obstetrics & Gynecology | Suite 966, 2900 Frank Scott Pkwy W, Belleville, IL 62223-5000 | 2006-09-01 |
| 1184644981 | Midwest Medical Healthcare, Ltd. | Obstetrics & Gynecology | 340 W Lincoln St Ste 560, Belleville, IL 62220-1900 | 2006-07-21 |
| 1467410373 | Gerard T Cicalese Md Pa | Obstetrics & Gynecology | 330 Washington Ave, Belleville, NJ 07109 | 2006-05-02 |
| 1477558922 | John A. Hucker | Obstetrics & Gynecology | 340 W Lincoln St, Ste 560, Belleville, IL 62220-1900 | 2005-06-20 |
| 1326452582 | James Hobby | Obstetrics & Gynecology | 7210 W Main St, Belleville, IL 62223 | 2014-06-16 |
| 1104118249 | Kallie L Harrison | Obstetrics & Gynecology | 4600 Memorial Dr Ste 400, Belleville, IL 62226-5366 | 2011-05-09 |
| Find all providers in BELLEVILLE | ||||
| City | BELLEVILLE |
| Zip Code | 62226 |
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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.