JOANN ILLINGSWORTH (NPI# 1841784667) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841784667 |
| Entity Type | Individual |
| Full Name | JOANN ILLINGSWORTH |
| Practice Address |
3975 Midway Dr Baker City OR 97814 |
| Mailing Address |
Po Box 1005 Baker City OR 97814-1005 |
| Practice Telephone | 5414064999 |
| Mailing Telephone | 5414064999 |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2018-06-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
3975 MIDWAY DR |
| City | BAKER CITY |
| State | OR |
| Zip Code | 97814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215421136 | Samuel Baxter | Counselor | 3975 Midway Dr, Baker City, OR 97867 | 2018-06-15 |
| 1487148201 | Teresa Cox-weems | Counselor | 3975 Midway Dr, Baker City, OR 97814 | 2018-06-15 |
| 1669966586 | Brenon Witty | Nurse's Aide | 3975 Midway Dr, Baker City, OR 97814 | 2018-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083279871 | Charles Henry Campos | Counselor | 2021 Court Street, Baker City, OR 97814 | 2019-05-07 |
| 1831546217 | Veronica Crowder | Physician Assistant | Samg Orthopedics Baker City, 3325 Pocahontas Rd, Baker City, OR 97814 | 2016-05-16 |
| 1013389956 | Dara Michelle Fields | Counselor | 2200 4th Street, Baker City, OR 97814 | 2015-10-29 |
| 1003223694 | Colleen Davenport | Nurse Practitioner | 3975 N Midway Dr, Baker City, OR 97814 | 2014-07-16 |
| 1629418363 | Sherry Melena Zacharias Forsyth | Counselor | 2100 Main St., New Directions, Baker City, OR 97814 | 2013-06-26 |
| 1609215573 | Logan Clay Frederickson | Family Medicine | 3820 17th Street, Baker City, OR 97814 | 2013-06-24 |
| 1790124485 | James Lee Morris | Counselor | 3610 Midway, Baker City, OR 97814 | 2013-06-17 |
| 1881955656 | New Directions Northwest, Inc | Substance Abuse Rehabilitation Facility | 3610 Midway Drive, Baker City, OR 97814 | 2012-06-07 |
| 1972864759 | New Directions Northwest, Inc. | Substance Abuse Rehabilitation Facility | 3700 Midway Drive, Baker City, OR 97814 | 2012-06-07 |
| 1659671113 | Al H Brickman | Pharmacist | 1205 Campbell St., Baker City, OR 97814 | 2010-10-29 |
| Find all providers in zip 97814 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215421136 | Samuel Baxter | Counselor | 3975 Midway Dr, Baker City, OR 97867 | 2018-06-15 |
| 1013389956 | Dara Michelle Fields | Counselor | 2200 4th Street, Baker City, OR 97814 | 2015-10-29 |
| 1205196813 | Mairi Ann Mcallister Nielsen | Counselor | 3610 Midway Dr, Baker City, OR 97814-1466 | 2012-05-17 |
| 1245507771 | Jeana L. Phillips | Counselor | 1937 Washington Ave, Baker City, OR 97814-3353 | 2011-11-29 |
| 1558988808 | Dylan Joseph-edward Chaves | Counselor | 3975 Midway Drive, Baker City, OR 97814 | 2020-07-02 |
| 1962027532 | Matthew Useda | Counselor | 3975 Midway Drive, Baker City, OR 97814-9781 | 2020-06-10 |
| 1386291672 | Shelley Devore | Counselor | 3425 13th St, Baker City, OR 97814-1340 | 2019-08-21 |
| 1770144396 | Ronda Kissire | Counselor | 3975 Midway Drive, Baker City, OR 97814 | 2019-06-25 |
| 1679134209 | Marla Vivian Petrik | Counselor | 3975 Midway Drive, Baker City, OR 97814 | 2019-06-25 |
| 1326609975 | Kristy Suzann Mcpherson | Counselor | 2200 4th St, Baker City, OR 97814-2615 | 2019-06-25 |
| Find all providers in BAKER CITY | ||||
| City | BAKER CITY |
| Zip Code | 97814 |
Please comment or provide details below to improve the information on JOANN ILLINGSWORTH.
| 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.