JOHN H. BRAXTON (NPI# 1073568655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073568655 |
| Entity Type | Individual |
| Full Name | JOHN H. BRAXTON |
| Credential | M.D. |
| Practice Address |
1340 Charles St Rockford IL 61104-2200 |
| Mailing Address |
Po Box 1567 Rockford IL 61110-0067 |
| Practice Telephone | 7796968800 |
| Mailing Telephone | 7796967150 |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2020-04-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 036144421 | IL | Allopathic & Osteopathic Physicians |
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 70145 | MT | Allopathic & Osteopathic Physicians |
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 55168 | WI | Allopathic & Osteopathic Physicians |
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 014598 | ME | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 336110099 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629417845 | John Keith Braxton | Contractor | 17615 Cypress Laurel St, Houston, TX 77095-4777 | 2013-06-20 |
| 1902809734 | John S Braxton IIi | Physician Assistant | 253 Lewis Ln, Suite 202, Havre De Grace, MD 21078-3750 | 2005-05-24 |
| Street Address |
1340 CHARLES ST |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61104-2200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063418143 | Kathleen Edna Williams | Nurse Practitioner | 1340 Charles St, Ste 201, Rockford, IL 61104 | 2005-06-23 |
| 1124526652 | Drew W Pearson | Registered Nurse | 1340 Charles St, Rockford, IL 61104-2200 | 2018-01-30 |
| 1417483322 | Andrea K Mehlbaum | Registered Nurse | 1340 Charles St, Suite 200, Rockford, IL 61104-2200 | 2017-05-11 |
| 1770030801 | Mary L Marshall | Registered Nurse | 1340 Charles St, Suite 300, Rockford, IL 61104-2200 | 2016-09-07 |
| 1518318047 | Laura G Padron | Registered Nurse | 1340 Charles St, Suite 300, Rockford, IL 61104 | 2016-06-27 |
| 1689056285 | Mary E Novotny | Registered Nurse | 1340 Charles St, Suite 100, Rockford, IL 61104 | 2015-06-19 |
| 1356759294 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St, Suite 300, Rockford, IL 61104 | 2014-07-23 |
| 1104237130 | John Russell | Registered Nurse | 1340 Charles St, Suite 300, Rockford, IL 61104 | 2014-05-13 |
| 1760824114 | Kaitlin L Georgiafandis | Physician Assistant | 1340 Charles St, Rockford, IL 61104-2200 | 2013-07-26 |
| 1326486895 | Daniel Clark Painter | Physical Medicine & Rehabilitation | 1340 Charles St, Suite 100, Rockford, IL 61104-2200 | 2013-06-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699216564 | Swedishamerican Hospital | Nutritionist | 1415 E. State St., Lower Level A3, Rockford, IL 61104 | 2017-03-13 |
| 1376950485 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 200, Rockford, IL 61104 | 2014-07-21 |
| 1871907774 | Oday Alsarraf | Psychiatry & Neurology | 1401 E State Street, Center for Mental Health, Swedish American Hospital, Rockford, IL 61104 | 2014-06-18 |
| 1962652339 | Children's Home and Aid | Community/Behavioral Health | 424 7th St, Rockford, IL 61104 | 2008-09-23 |
| 1689729535 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 100, Rockford, IL 61104 | 2007-01-23 |
| 1790873016 | David J Schleicher | Obstetrics & Gynecology | 209 9th St Ste 200, Rockford, IL 61104 | 2006-10-11 |
| 1013026624 | Thomas Ryan Moss | Dentist | 1415 E State Street, Rockford, IL 61104 | 2006-08-29 |
| 1366452096 | Arturo Santiago Manas | Obstetrics & Gynecology | 1415 E State St Fl 8, Rockford, IL 61104 | 2006-08-08 |
| 1245263268 | William John Stout | Physician Assistant | 1401 E State Street, Rockford, IL 61104 | 2006-07-10 |
| 1689604969 | Prabha Chand Dosi | Pediatrics | 1401 E. State Street, Rockford, IL 61104 | 2006-07-03 |
| Find all providers in zip 61104 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528092194 | Thomas J Stieglitz | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5668 E State St, Rockford, IL 61108-2490 | 2006-07-10 |
| 1255364139 | Thomas Lloyd Carter Jr. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5668 E State St, Rockford, IL 61108-2490 | 2006-07-07 |
| 1174553523 | John Carlton Myers | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1340 Charles St Ste 300, Rockford, IL 61104-2200 | 2006-07-03 |
| 1609826312 | Fernando Neves Lamounier | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2400 N. Rockton Ave, Rockford Health Physicians, Rockford, IL 61103 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205363041 | Sachowdhry | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1 S Summit Ave, Oakbrook Terrace, IL 60181-2212 | 2017-05-11 |
| 1760930028 | Hiroto Kitahara | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5841 S. Maryland Avenue M/c6040, Chicago, IL 60637 | 2016-09-15 |
| 1720440282 | Azad Karim | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 441 E Erie St Apt 1803441, Chicago, IL 60611-4446 | 2016-03-24 |
| 1982002838 | Milton Weinberg Jr. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 983 Kirkhill Ln, Lake Forest, IL 60045-4209 | 2014-12-09 |
| 1235557190 | Bartlomiej Imielski | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 201 E. Huron St., Galter 11-140, Chicago, IL 60611 | 2014-03-28 |
| 1841635869 | Aaron Maxwell Kime | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 133 E Brush Hill Rd Ste 200, Elmhurst, IL 60126-5661 | 2013-05-03 |
| 1952744823 | Walter Lee Barker | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2912 N. Commonwealth Ave., #11c, Chicago, IL 60657-6235 | 2013-04-10 |
| 1952641649 | Willard A Fry | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1500 Sheridan Rd, #10e, Wilmette, IL 60091-1873 | 2013-02-18 |
| 1487903092 | Horizons In Healthcare LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 372 Red Bud Ct., Frankfort, IL 60423-2128 | 2012-08-29 |
| 1518215284 | Paul Naffah | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 6161 So County Line Rd, Burr Ridge, IL 60527 | 2012-08-28 |
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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.