Kelly L Magoon (NPI# 1811303217, PAC ID# 6507085479) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
Nation Provider ID (NPI) | 1811303217 |
PAC ID by PECOS | 6507085479 |
Professional Enrollment ID | I20140909000819 |
Full Name | Kelly L Magoon |
Organization Legal Name | CARLSON ORTHOPEDIC CLINIC SC |
Address |
1848 Daimler Rd Rockford IL 61112-1019 |
Phone Number | 8153989100 |
Gender | F |
Graduation Year | 2014 |
Primary Specialty | PHYSICIAN ASSISTANT |
Group Practice PAC ID | 6901971316 |
Number of Group Practice Members | 3 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
140233 | OSF SAINT ANTHONY MEDICAL CENTER |
Address | Phone | Organization |
---|---|---|
1848 Daimler Rd, Rockford, IL 61112-1019 | 8153989100 | CARLSON ORTHOPEDIC CLINIC SC |
Organization Legal Name | CARLSON ORTHOPEDIC CLINIC SC |
Physicians | 2 |
Name | Specialty | Organization | Address |
---|---|---|---|
Mark E Carlson | Orthopedic Surgery | Carlson Orthopedic Clinic Sc | 1848 Daimler Rd, Suite 1, Rockford, IL 61112-1019 |
Street Address |
1848 DAIMLER RD |
City | ROCKFORD |
State | IL |
Zip | 61112-1019 |
Name | Specialty | Organization | Address |
---|---|---|---|
Mark E Carlson | Orthopedic Surgery | Carlson Orthopedic Clinic Sc | 1848 Daimler Rd, Suite 1, Rockford, IL 61112-1019 |
Name | Specialty | Organization | Address |
---|---|---|---|
Wingyin Hui | Optometry | Facchiano and Associates PC | E265 Cherryvale Mall, Rockford, IL 61112 |
James C Wooldridge | Optometry | Wooldridge Optometry LLC | 7200 Harrison Ave, E265, Rockford, IL 61112-1017 |
Glennetta M Coleman | Internal Medicine | 1893 Daimler Rd, Rockford, IL 61112-1081 | |
Brant D Hulsebus | Chiropractic | Hulsebus Rockford Chiropractic | 1877 Daimler Rd, Rockford, IL 61112-1098 |
Craig A Stear Jr. | Chiropractic | Hulsebus Rockford Chiropractic | 1877 Daimler Rd, Rockford, IL 61112-1098 |
Joshua Berven | Chiropractic | Hulsebus Rockford Chiropractic | 1877 Daimler Rd, Rockford, IL 61112-1098 |
Nathaniel Hays | Chiropractic | Hulsebus Rockford Chiropractic | 1877 Daimler Rd, Rockford, IL 61112-1098 |
City | ROCKFORD |
Zip Code | 61112 |
Specialty | PHYSICIAN ASSISTANT |
City + Specialty | ROCKFORD + PHYSICIAN ASSISTANT |
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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.