MR. ROGER SMITH (NPI# 1841305463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841305463 |
| Entity Type | Individual |
| Full Name | MR. ROGER SMITH |
| Credential | PAC |
| Practice Address |
510 Lincoln Drive Southern Orthopedic Associates Sc Herrin IL 62948 |
| Practice Telephone | 6189976800 |
| Practice Fax Number | 6189989124 |
| Mailing Telephone | 6189976800 |
| Mailing Fax Number | 6189989124 |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043720147 | Roger Smith Jr. | Behavior Technician | 4241 Soto St, Riverside, CA 92509-3446 | 2017-10-04 |
| 1124211081 | Roger Paul Smith | Chiropractor | 9755 N 90th St Ste A203, Scottsdale, AZ 85258-5079 | 2007-08-23 |
| 1487868196 | Roger Dale Smith | Homemaker | 509 Ward Ave, Caruthersville, MO 63830-1661 | 2007-05-10 |
| 1245324904 | Roger D Smith | Dentist | 933 Russell Rd Ste 103, Columbia, KY 42728-1054 | 2006-10-03 |
| 1801905054 | Roger Gordon Smith | Internal Medicine | 1030 Jefferson Ave Dept 11c, Memphis, TN 38104-2127 | 2006-08-30 |
| 1184730467 | Roger A Smith | Chiropractor | 286 Montevue Ln, Frederick, MD 21702-8212 | 2006-08-21 |
| 1922015403 | Roger M. Smith | Social Worker | 14317 Hickory Dr., Ponchatoula, LA 70454-6653 | 2006-08-01 |
| 1144257536 | Roger Raymond Smith | Specialist | 909 Hyde St., Suite #531, San Francisco, CA 94106-0001 | 2006-06-28 |
| 1003872631 | Roger Mcdonnell Smith | Psychiatry & Neurology | 4125 Landisville Rd, Doylestown, PA 18902 | 2006-04-22 |
| 1831163385 | Roger P Smith | Obstetrics & Gynecology | 2801 Brookline Ct, Zionsville, IN 46077-1194 | 2006-02-13 |
| Street Address |
510 LINCOLN DRIVE SOUTHERN ORTHOPEDIC ASSOCIATES SC |
| City | HERRIN |
| State | IL |
| Zip Code | 62948 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922008754 | Bret Hunter Miller | Orthopaedic Surgery | 510 Lincoln Drive, Herrin, IL 62948-6334 | 2005-07-22 |
| 1659890069 | Nicole L Cheek | Physical Therapist | 510 Lincoln Drive, Herrin, IL 62901 | 2017-09-18 |
| 1578923660 | Kaily Marie Palmer | Physical Therapist | 510 Lincoln Drive, Herrin, IL 62948 | 2016-03-02 |
| 1841447026 | Richard P Vicenzi | Specialist/Technologist | 510 Lincoln Drive, Herrin, IL 62948 | 2008-08-19 |
| 1295998011 | Jeffery M. Jones | Neurological Surgery | 510 Lincoln Drive, Herrin, IL 62948 | 2008-07-02 |
| 1518152404 | Eric Jay Osman | Physical Therapist | 510 Lincoln Drive, Herrin, IL 62948 | 2007-09-13 |
| 1386716884 | Jeremy Dale Palmer | Orthopaedic Surgery | 510 Lincoln Drive, Southern Orthopedic Associates Sc, Herrin, IL 62948 | 2006-11-14 |
| 1154425882 | John B Wood | Orthopaedic Surgery | 510 Lincoln Drive, Southern Orthopedic Associates Sc, Herrin, IL 62948 | 2006-09-12 |
| 1063516797 | James Michael Davis | Orthopaedic Surgery | 510 Lincoln Drive, Southern Orthopedic Associates Sc, Herrin, IL 62948 | 2006-09-12 |
| 1215031943 | Steven D Young | Orthopaedic Surgery | 510 Lincoln Drive, Southern Orthopedic Associates Sc, Herrin, IL 62948 | 2006-09-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215307590 | Carmelito Miralles Caronongan | Pediatrics | 120 S. 11th St., Herrin, IL 62948 | 2015-09-30 |
| 1073995684 | Motaz R Wraikat | Preventive Medicine | 315 S 13th St Ste 3, Herrin, IL 62948 | 2015-06-19 |
| 1639427933 | Salim Hosein | Surgery | 317 S 14th St Ste 1, Herrin, IL 62948 | 2012-08-17 |
| 1962780288 | Pooja Sareen | Internal Medicine | 3024 S Park Avenue, Herrin, IL 62948 | 2011-08-03 |
| 1235459918 | Timoteo Castro Md & Josefina D. Castro Md Ltd | Family Medicine | 321 South 13st St., Herrin, IL 62948 | 2010-06-04 |
| 1457501926 | Don Cassidy Arnold II | Urology | 220 S Park Ave Fl 2, Herrin, IL 62948 | 2008-09-22 |
| 1306094560 | Karl Keith Mitchener | Speech-Language Pathologist | 1901 N 13th Street, Herrin, IL 62948 | 2008-08-29 |
| 1457509705 | Kathryn Marie Bordenet-jines | Occupational Therapy Assistant | 1901 N. 13th, Herrin, IL 62948 | 2008-08-28 |
| 1417105776 | Cheryl Lynn Matic | Occupational Therapy Assistant | 1901 N. 13th St., Herrin, IL 62948 | 2008-08-28 |
| 1174771422 | Mary Frances Graham | Physical Therapy Assistant | 1901 N. 13th Street, Herrin, IL 62948 | 2008-08-28 |
| Find all providers in zip 62948 | ||||
| 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 |
|---|---|---|---|---|
| 1336266428 | Sylvia Ann Chalem | Physician Assistant | 304 N 14th St, Herrin, IL 62948-3102 | 2007-03-23 |
| 1841307014 | Michele Behm | Physician Assistant | 3316 Patriot Ct, Herrin, IL 62948-3782 | 2006-08-24 |
| 1447297676 | Isaac A Roberg | Physician Assistant | 408 Lincoln Dr Ste B, Herrin, IL 62948-3790 | 2006-05-31 |
| 1770059305 | Richard Cardall Mitchell | Physician Assistant | 201 S 14th St, Herrin, IL 62948-3631 | 2018-10-22 |
| 1770032948 | Austin Michael Stallings | Physician Assistant | 405 Rushing Dr, Herrin, IL 62948-3730 | 2016-09-28 |
| 1750632691 | Rachel L Terrill | Physician Assistant | 405 Rushing Dr, Herrin, IL 62948-3730 | 2012-10-01 |
| 1255681557 | Kallie M French | Physician Assistant | 405 Rushing Dr, Herrin, IL 62948-3730 | 2012-09-13 |
| 1942550272 | Natalie Spiller | Physician Assistant | 220 N Park Ave, Herrin, IL 62948-3150 | 2012-09-13 |
| 1235412982 | Kelly Jackson Johnson | Physician Assistant | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2011-09-20 |
| 1154659894 | Hollis Johnson Clark Jr. | Physician Assistant | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2009-11-18 |
| Find all providers in HERRIN | ||||
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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.