GACHUGU MEDICAL CLINIC (NPI# 1003414442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003414442 |
| Entity Type | Organization |
| Organization Name | GACHUGU MEDICAL CLINIC |
| Practice Address |
1 E Ferguson Ave Wood River IL 62095-1903 |
| Practice Telephone | 6182518138 |
| Practice Fax Number | 6182518140 |
| Mailing Telephone | 6189179464 |
| Enumeration Date | 2020-10-16 |
| Last Update Date | 2020-10-23 |
| Authorized Official Name | MR. WILSON GACHUGU NDUNGU (AUTHORIZED OFFICIAL/OWNER) |
| Authorized Official Telephone | 6189179463 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1 E FERGUSON AVE |
| City | WOOD RIVER |
| State | IL |
| Zip Code | 62095-1903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467698068 | Jkh Management, LLC | Clinic/Center | 1138 Vaughn Road, Wood River, IL 62095 | 2009-01-02 |
| 1972762367 | Ronald Weems Jr P.C. | Dentist | 1915 Vaughn Road, Wood River, IL 62095 | 2008-06-02 |
| 1306010913 | Kristin Nicole Kellim | Specialist | 1138 Vaughn Rd, Wood River, IL 62095 | 2008-04-15 |
| 1124240569 | Denise Marie Jacquin | Optometrist | 650 Wesley Drive, Wood River Centre, Wood River, IL 62095 | 2007-05-03 |
| 1982734414 | Kathleen Crockett | Physical Therapist | 400 S Main, Wood River, IL 62095 | 2007-03-06 |
| 1336200286 | Johan C Dinkelmann | Chiropractor | 21 E Acton Ave, Wood River, IL 62095 | 2006-12-13 |
| 1760418099 | Hagopian Shoes, LLC | Prosthetic/Orthotic Supplier | 48 E Ferguson Ave, Wood River, IL 62095 | 2006-06-26 |
| 1063470524 | Jerseyville Pain Management Center, S.c. | Chiropractor | 1702 Vaughn Rd, Wood River, IL 62095 | 2006-05-03 |
| 1831354257 | Benjamin Hite | Dentist | 1915 Vaughn Road, Wood River, IL 62095 | 2008-07-24 |
| 1679797294 | Rhonda Nemsky | Developmental Therapist | 400 S Main, Wood River, IL 62095 | 2007-04-13 |
| Find all providers in zip 62095 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417410200 | Laura Burton | Nurse Practitioner | 203 E Ferguson Ave, Wood River, IL 62095-2001 | 2019-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578523 | Kaitlin Lawson Kalnitz | Nurse Practitioner | 745 Mcclintock Dr Ste 360, Burr Ridge, IL 60527-0875 | 2020-11-06 |
| 1841890290 | Maria Malanych | Nurse Practitioner | 5731 Rosinweed Ln, Naperville, IL 60564-1635 | 2020-10-27 |
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1295334811 | Mary Farley | Nurse Practitioner | 7308 Northwood Dr, Wonder Lake, IL 60097-8606 | 2020-10-24 |
| 1164021168 | Stephanie Schuster | Nurse Practitioner | 2665 Prairieview Ln N, Aurora, IL 60502-6343 | 2020-10-21 |
| 1316546641 | Vanessa K Bajaj | Nurse Practitioner | 1123 N Claremont Dr, Palatine, IL 60074-4002 | 2020-10-19 |
| 1477151272 | Yolanda K Bradford | Nurse Practitioner | 2700 S California Ave, Chicago, IL 60608-5108 | 2020-10-14 |
| 1265030019 | Andrea Mclean | Nurse Practitioner | 2500 W Reynolds St # 205, Pontiac, IL 61764-9774 | 2020-10-14 |
| 1558968628 | Timothy Nenoff | Nurse Practitioner | 24722 Lincolnway St, Plainfield, IL 60544-2412 | 2020-10-02 |
| 1467069823 | Alicia Nicole Kendra | Nurse Practitioner | Upliftedcare, 482 Main St. Nw, Bourbonnais, IL 60914 | 2020-09-29 |
| Find all providers with the same taxonomy | ||||
| City | WOOD RIVER |
| Zip Code | 62095 |
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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.