Stella C Johnson (NPI# 1437556800, PAC ID# 2365767803) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1437556800 |
| PAC ID by PECOS | 2365767803 |
| Professional Enrollment ID | I20150204001918 |
| Full Name | Stella C Johnson |
| Organization Legal Name | PHYSICIAN SERVICES CORPORATION OF SOUTHERN ILLINOIS INC |
| Address |
5 Good Samaritan Way Mount Vernon IL 62864-2402 |
| Phone Number | 6188991264 |
| Gender | F |
| Graduation Year | 2014 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 9234022567 |
| Number of Group Practice Members | 88 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140046 | SSM HEALTH - GOOD SAMARITAN HOSPITAL |
| 141311 | FAIRFIELD MEMORIAL HOSPITAL 1 |
| Address | Phone | Organization |
|---|---|---|
| 2 Good Samaritan Way, Suite 320, Mount Vernon, IL 62864-2408 | 6188991944 | PHYSICIAN SERVICES CORPORATION OF SOUTHERN ILLINOIS INC |
| 5 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 6188991264 | PHYSICIAN SERVICES CORPORATION OF SOUTHERN ILLINOIS INC |
| 1259 W Robinson St, Wayne City, IL 62895-9672 | 6188953181 | PHYSICIAN SERVICES CORPORATION OF SOUTHERN ILLINOIS INC |
| Organization Legal Name | PHYSICIAN SERVICES CORPORATION OF SOUTHERN ILLINOIS INC |
| Physicians | 62 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jessica Lynn Chapman | Nurse Practitioner | Physician Services Corporation of Southern Illinois Inc | 1003 E Mccord St, Centralia, IL 62801-3345 |
| Murugavel M Muthusamy | Hematology/oncology | Physician Services Corporation of Southern Illinois Inc | 1052 Martin Luther King Dr, Suite 100, Centralia, IL 62801-3002 |
| Darla J Spain | Nurse Practitioner | Physician Services Corporation of Southern Illinois Inc | 501 N Du Quoin St, Benton, IL 62812-1224 |
| Tamara E Copeland | Nurse Practitioner | Physician Services Corporation of Southern Illinois Inc | 4106 S Water Tower Pl, Mount Vernon, IL 62864-6544 |
| Katina Candee | Physician Assistant | Physician Services Corporation of Southern Illinois Inc | 602 S 42nd St B, Mount Vernon, IL 62864-6264 |
| Karla R Webb | Nurse Practitioner | Physician Services Corporation of Southern Illinois Inc | 402 N Pleasant Ave, Centralia, IL 62801-3006 |
| Melissa Karaffa | Nurse Practitioner | Physician Services Corporation of Southern Illinois Inc | 1054 M L King Dr, Centralia, IL 62801-3066 |
| Debra Ann Carson | Obstetrics/gynecology | Physician Services Corporation of Southern Illinois Inc | 201 Bailey Ln, Benton, IL 62812-1969 |
| Nida Subhani | Internal Medicine | Physician Services Corporation of Southern Illinois Inc | 602 S 42nd St, B, Mount Vernon, IL 62864-6264 |
| Naresh K Ahuja | General Surgery | Physician Services Corporation of Southern Illinois Inc | 2 Good Samaritan Way, Suite 235, Mount Vernon, IL 62864-2476 |
| Street Address |
5 GOOD SAMARITAN WAY |
| City | MOUNT VERNON |
| State | IL |
| Zip | 62864-2402 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nelson K Wong | Family Medicine | Physician Services Corporation of Southern Illinois Inc | 5 Good Samaritan Way, Mount Vernon, IL 62864-2402 |
| Kimberly A Belangee | Nurse Practitioner | Physician Services Corporation of Southern Illinois Inc | 5 Good Samaritan Way, Mount Vernon, IL 62864-2402 |
| Dawn Drewes | Nurse Practitioner | Physician Services Corporation of Southern Illinois Inc | 5 Good Samaritan Way, Mount Vernon, IL 62864-2402 |
| Herbert J Huston | Physician Assistant | Physician Services Corporation of Southern Illinois Inc | 5 Good Samaritan Way, Mount Vernon, IL 62864-2402 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christa S Pestka | Family Medicine | Christopher Greater Area Rural Health Planning Corp | 2920 Veterans Pkwy, Mount Vernon, IL 62864 |
| Jacklyn Hedger | Nurse Practitioner | Christopher Greater Area Rural Health Planning Corp | 2920 Veterans Pkwy, Mount Vernon, IL 62864 |
| Lydia Ann Williams | Psychologist, Clinical | 4230 Lincolnshire Dr E, Mount Vernon, IL 62864-2189 | |
| Linden R Pearson | Family Medicine | 4230 Lincolnshire Dr G, Mount Vernon, IL 62864-2189 | |
| Kevin C Wright | Diagnostic Radiology | Virtual Radiologic Professionals LLC | 3614 Victoria Ave, Mount Vernon, IL 62864-2208 |
| Mark C Hurst | Optometry | 4 Westwood Dr, Mount Vernon, IL 62864-2212 | |
| Jennifer L Craig | Optometry | J Bass Ltd | 112 S 42nd St, Mount Vernon, IL 62864-2243 |
| Jennifer R Bass | Optometry | J Bass Ltd | 112 S 42nd St, Mount Vernon, IL 62864-2243 |
| Troy W Johnson | Optometry | Clarkson Optometry Illinois PC | 3000 Broadway St, Mount Vernon, IL 62864-2340 |
| Erin Hocking Ayers | Optometry | Marion Eye Centers Ltd | 2900 Broadway St A, Mount Vernon, IL 62864-2341 |
| Find all physicians in zip 62864 | |||
| City | MOUNT VERNON |
| Zip Code | 62864 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | MOUNT VERNON + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.