HEARTLAND SPINE, LLC (NPI# 1144478330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144478330 |
| Entity Type | Organization |
| Organization Name | HEARTLAND SPINE, LLC |
| Practice Address |
3905 W Ernestine Dr Marion IL 62959-5800 |
| Mailing Address |
3250 Gordonville Rd Suite 450 Cape Girardeau MO 63703-5056 |
| Practice Telephone | 5733315761 |
| Practice Fax Number | 5733315762 |
| Mailing Telephone | 5733315761 |
| Mailing Fax Number | 5733315762 |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2008-09-03 |
| Authorized Official Name | FRANKLIN HAYWARD II (PRESIDENT) |
| Authorized Official Telephone | 5733315761 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | 2006012799 | MO | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528215332 | Heartland Spine, LLC | Neurological Surgery | 3250 Gordonville Rd, Suite 450, Cape Girardeau, MO 63703-5056 | 2008-08-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | HEARTLAND SPINE, LLC | 304 S Mount Auburn Rd, Cape Girardeau, MO 63703-4920 |
| Street Address |
3905 W ERNESTINE DR |
| City | MARION |
| State | IL |
| Zip Code | 62959-5800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942227863 | Southern Illinois Pain Management | Specialist | 3905 W Ernestine Dr, Marion, IL 62959-5800 | 2006-07-16 |
| 1801211784 | Emily Sumner | Occupational Therapist | 3905 W Ernestine Dr, Suite B, Marion, IL 62959-5800 | 2014-02-28 |
| 1881947612 | Brynn Erin Basinger | Speech-Language Pathologist | 3905 W Ernestine Dr, Suite B, Marion, IL 62959-5800 | 2012-10-17 |
| 1679861710 | Daniel Lee Porter | Occupational Therapist | 3905 W Ernestine Dr, Suite B, Marion, IL 62959-5800 | 2011-07-11 |
| 1538314414 | Performance Chiropractic of Southern Illinois LLC | Chiropractor | 3905 W Ernestine Dr, Suite B, Marion, IL 62959-5800 | 2008-11-19 |
| 1154506228 | Julie T Tiu | Physical Therapist | 3905 W Ernestine Dr, Suite B, Marion, IL 62959-5800 | 2008-01-08 |
| 1689859944 | Sarah Renee Surprenant | Occupational Therapist | 3905 W Ernestine Dr, Suite B, Marion, IL 62959-5800 | 2008-01-07 |
| 1972788305 | David A Martin | Occupational Therapist | 3905 W Ernestine Dr, Suite B, Marion, IL 62959-5800 | 2008-01-03 |
| 1295933315 | Robert J Marsh | Psychologist | 3905 W Ernestine Dr, Marion, IL 62959-5800 | 2007-07-10 |
| 1659439081 | Ryan August Gullett | Chiropractor | 3905 W Ernestine Dr, Suite B, Marion, IL 62959-5800 | 2006-12-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710513486 | Sarah Benitone | Counselor | 11264 Il-37, Marion, IL 62959 | 2020-03-13 |
| 1528609328 | Patricia E Murphy | Radiology | 4503 1/2 W Deyoung, Suite 3a, Marion, IL 62959 | 2019-10-02 |
| 1366007007 | Centerstone of Illinois, Inc | Community/Behavioral Health | 202 S Bentley St, Marion, IL 62959 | 2019-05-08 |
| 1649752064 | Sydney Seiter | Occupational Therapist | 906 Skyline Suite 100, Marion, IL 62959 | 2018-09-01 |
| 1497279848 | Brooke Alisa Osman | Licensed Practical Nurse | 11531 Sunderland Road, Marion, IL 62959 | 2017-07-27 |
| 1912436429 | Joy L. Kee | Social Worker | 509 South Bentley Street, Marion, IL 62959 | 2017-06-08 |
| 1386181170 | Susan Smothers | Counselor | 1305 West Main Street, Marion, IL 62959 | 2017-01-31 |
| 1205280922 | Harish Kempegowda | Orthopaedic Surgery | 3331 W Deyoung St Ste 201, Marion, IL 62959 | 2016-04-19 |
| 1942609227 | Casey Hill | Social Worker | 1604 W. Walnut St., Marion, IL 62959 | 2014-08-22 |
| 1306252812 | Justin M White | Chiropractor | 1603 W Kimmel, Marion, IL 62959 | 2014-07-03 |
| Find all providers in zip 62959 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205074093 | Allan C Gocio Md Neurosurgical Care, LLC | Neurological Surgery | 3331 W Deyoung St, Ste 308, Marion, IL 62959-5896 | 2009-02-02 |
| 1467477901 | Chad Michael Miller | Neurological Surgery | 1000 Mckinley Park Dr, Marion, OH 43302-6399 | 2006-07-13 |
| 1164480851 | Noel N Eboh | Neurological Surgery | 1040 Delaware Avenue, Marion, OH 43301-1814 | 2006-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871114371 | Justin Michael | Neurological Surgery | 701 N 1st St Ste D-319, Springfield, IL 62702-3757 | 2020-05-06 |
| 1023678638 | Matthew Weber | Neurological Surgery | 701 N 1st St, Suite D-319, Springfield, IL 61702 | 2019-06-17 |
| 1891281499 | Kamran Khan, Sc | Neurological Surgery | 1890 Silver Cross Blvd Ste 450, New Lenox, IL 60451-9518 | 2018-07-06 |
| 1881124030 | Denise Brunozzi | Neurological Surgery | 912 South Wood Street, 451 N - Hc 739, Chicago, IL 60612 | 2017-06-19 |
| 1407218365 | St Anthonys Physician Organization of Illinois | Neurological Surgery | 211 S Burns Ave, Sparta, IL 62286-1895 | 2016-03-22 |
| 1225455181 | Jehad Algharabli | Neurological Surgery | 2218 S Leavitt St, Chicago, IL 60608-4008 | 2014-03-27 |
| 1992041461 | Gursant Atwal | Neurological Surgery | University of Il Hospital & Health Science System, 1740 W Taylor St, Chicago, IL 60612 | 2013-01-02 |
| 1629321112 | James Bruce Mansfield | Neurological Surgery | 5 Loch Ln, South Barrington, IL 60010-9532 | 2012-10-21 |
| 1639445877 | Joseph R Rivas | Neurological Surgery | 511 W Belmont Ave, #32, Chicago, IL 60657-4663 | 2012-03-30 |
| 1356637722 | Melissa M Stamates | Neurological Surgery | 2650 Ridge Ave Fl 3, Evanston, IL 60201 | 2011-06-23 |
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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.