BONHAM EMERGENCY MEDICINE LLC (NPI# 1861654774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1861654774 |
Entity Type | Organization |
Organization Name | BONHAM EMERGENCY MEDICINE LLC |
Other Organization Name | GEMS EXPRESS CARE |
Practice Address |
76 Carlyle Plaza Dr Belleville IL 62221-6677 |
Practice Telephone | 6184166560 |
Practice Fax Number | 6184166561 |
Mailing Telephone | 6184166560 |
Mailing Fax Number | 6184166561 |
Enumeration Date | 2008-07-01 |
Last Update Date | 2012-01-24 |
Authorized Official Name | RUBY F YATES (PRESIDENT) |
Authorized Official Telephone | 6182775974 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
GEMS Express Care | Doing Business As Name - Organization |
Street Address |
76 CARLYLE PLAZA DR |
City | BELLEVILLE |
State | IL |
Zip Code | 62221-6677 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679134829 | Dr. Cynthia C. Banderet, Dmd, PC | Clinic/Center | 2630 Mascoutah Ave., Suite A, Belleville, IL 62221 | 2019-06-27 |
1942763487 | John Joseph Oldani | Psychologist | Bassc - Belleville Area Special Services Cooperative, 2411 Pathways Crossing, Belleville, IL 62221 | 2019-04-11 |
1114497781 | Kendra D Edwards | Counselor | 900 Royal Height Rd Suite 2150, Belleville, IL 62221 | 2018-11-27 |
1326537358 | Barbara S Laidlaw | Counselor | 2362 Country Rd, Belleville, IL 62221 | 2018-05-04 |
1083133946 | Kierra Jackson | In Home Supportive Care | 2611 Sierra Drive Apt. F, Belleville, IL 62221 | 2017-09-12 |
1972022994 | Kathleen Denise Defranco | Speech-Language Pathologist | 2028 Lebanon Ave., Belleville, IL 62221 | 2017-09-11 |
1700302270 | Mark Hofelich | Pharmacist | 515 Carlyle Avenue, Belleville, IL 62221 | 2017-08-16 |
1912422247 | Cherie Ann Klosterman | Psychologist | Belleville Area Special Services Cooperative, 2411 Pathways Crossing, Belleville, IL 62221 | 2017-08-08 |
1134391329 | Barbara Beckley | Home Health Aide | 2726 Cascade Lake Drive, Shiloh, IL 62221 | 2008-03-27 |
1356561666 | Belleville Area Spc Srv Co - Adm | Local Education Agency (LEA) | 2411 Pathways Crossing, Belleville, IL 62221 | 2007-04-27 |
Find all providers in zip 62221 |
Taxonomy Code | 207Q00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417591173 | Dimi Dawn Resch | Family Medicine | 373 Roanoke Dr, Belleville, IL 62221-5723 | 2019-11-05 |
1013559749 | Christine Evansco | Family Medicine | 105 S 35th St, Belleville, IL 62226-6314 | 2019-10-15 |
1851800288 | Republic County Family Clinic, P.a. | Family Medicine | 2337 G St Ste 2, Belleville, KS 66935-2462 | 2017-09-28 |
1154854008 | Kurtis William Klecan | Family Medicine | 2337 G St Ste 100, Belleville, KS 66935-2462 | 2017-04-07 |
1144753096 | Ace Medical Services LLC | Family Medicine | 929 Ridgecrest Dr, Belleville, IL 62220-3163 | 2017-04-07 |
1558743138 | Patrick Nakashima-moran | Family Medicine | 2900 Frank Scott Pkwy W Ste 904, Belleville, IL 62223 | 2015-06-19 |
1871993139 | Wayne Bresee Cox II | Family Medicine | 10 Celeste Ct, Belleville, IL 62223-1907 | 2014-08-23 |
1811252547 | Jianming Alexander Lau | Family Medicine | 201 3rd St 200, Belleville, MI 48111-2605 | 2012-07-09 |
1548531320 | Donald H Buser | Family Medicine | 116 S Fairway Dr, Belleville, IL 62223-2228 | 2012-01-25 |
1275824096 | Pc Associates LLC | Family Medicine | 2129 W. Main St., Belleville, IL 62223 | 2011-04-27 |
Find all providers in BELLEVILLE |
City | BELLEVILLE |
Zip Code | 62221 |
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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.