MR. GEOFFERY BEATTY (NPI# 1184810970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184810970 |
| Entity Type | Individual |
| Full Name | MR. GEOFFERY BEATTY |
| Credential | RN |
| Practice Address |
2400 N Rockton Ave Rockford IL 61103-3655 |
| Practice Telephone | 8159715000 |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2014-06-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WC0400X |
Registered Nurse Specialization: Case Management |
041323569 | IL | Nursing Service Providers |
| Y | 163WE0003X |
Registered Nurse Specialization: Emergency |
041-323569 | IL | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | IDPR | 041-323569 | 01 |
| Street Address |
2400 N ROCKTON AVE |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61103-3655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457357592 | Michael J Kikta | Surgery | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2005-06-23 |
| 1053950055 | Tina Longphee | Registered Nurse | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2019-12-23 |
| 1598227407 | Shahid Mohammad | Student in an Organized Health Care Education/Training Program | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2019-04-01 |
| 1265993109 | Sarah Elaine Robertson | Student in an Organized Health Care Education/Training Program | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2019-03-25 |
| 1770042525 | Vinita Patel | Student in an Organized Health Care Education/Training Program | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2019-03-19 |
| 1255890646 | Gilda Djabarzade | Student in an Organized Health Care Education/Training Program | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2019-03-15 |
| 1285103002 | Amy Lask | Nurse Practitioner | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2018-11-21 |
| 1477038743 | Michelle Harris | Advanced Practice Midwife | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2018-10-02 |
| 1134603095 | Sarah R Linder | Nurse Practitioner | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2018-09-17 |
| 1376022350 | Atiq Urrehman Khan | Psychiatry & Neurology | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2018-08-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598398497 | The Elitist Group | Home Health Aide | 2929 N Main Street, Rockford, IL 61103 | 2020-02-19 |
| 1972064194 | Mahita Bellamkonda | Student in an Organized Health Care Education/Training Program | 2400 North Rockton Avenue, Rockford, IL 61103 | 2019-03-29 |
| 1558538967 | Willows Health Center | Clinic/Center | 4143 Albright Lane, Rockford, IL 61103 | 2008-05-14 |
| 1497845135 | Humaira Bari | Internal Medicine | 2400 N. Rockton Avenue, Rockford, IL 61103 | 2006-10-13 |
| 1841385242 | Rachel Pawlowski | Occupational Therapist | 3616 N. Main Street, Rockford, IL 61103 | 2006-10-03 |
| 1417068438 | Alicia Anne Huntley | Midwife | 2400 Rockton Ave, Rockford, IL 61103 | 2006-08-31 |
| 1639190200 | Glendon Burress | Pediatrics | 2300 N. Rockton Ave., Rockford Health Physicians, Rockford, IL 61103 | 2006-07-21 |
| 1225065204 | Daniel William Johnson | Dentist | 519 Toner Av, Rockford, IL 61103 | 2006-06-27 |
| 1760472898 | Ronald Peter Oberfoell | Anesthesiology | 2400 North Rockton Ave, Rockford Health Physicians, Rockford, IL 61103 | 2005-10-28 |
| 1841752532 | Dipti Sabharwal | Student in an Organized Health Care Education/Training Program | 2400 N Rockton Avenue, Rockford, IL 61103 | 2019-04-02 |
| Find all providers in zip 61103 | ||||
| Taxonomy Code | 163WE0003X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Emergency |
| Definition to come... |
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|---|---|---|---|---|
| 1417567348 | Victoria Banda | Registered Nurse | 600 Thames Pkwy Apt 1b, Park Ridge, IL 60068-3662 | 2020-08-05 |
| 1336772052 | Monica Melanie Rauch | Registered Nurse | 1111 Holly Ct Apt 317, Oak Park, IL 60301-1019 | 2020-02-20 |
| 1568012292 | Marta N Gonzalez | Registered Nurse | 2102 183rd St, Homewood, IL 60430-3231 | 2019-09-15 |
| 1174180285 | Sandra Michelle Weeks | Registered Nurse | 1750 N Meade Ave, Chicago, IL 60639-3910 | 2019-05-23 |
| 1477018927 | Jacob Benjamin Blount | Registered Nurse | 1224 Reynolds Dr, Charleston, IL 61920-2436 | 2019-02-08 |
| 1821573072 | Ugochinyere Ohaja | Registered Nurse | 5656 South Maryland Avenue, Chicago, IL 60637 | 2018-10-03 |
| 1003308347 | Elizabeth Ann Floyd | Registered Nurse | 1701 Glenbridge Rd, Bloomington, IL 61704-8710 | 2018-06-02 |
| 1174020788 | Emily M Bicanic | Registered Nurse | 870 N Milwaukee Ave Ste 100, Vernon Hills, IL 60061-1521 | 2018-04-10 |
| 1033625025 | Jessica Taylor | Registered Nurse | 44 W Center Ave, Lake Bluff, IL 60044-2408 | 2017-12-28 |
| 1912352089 | Jennifer Dunlop | Registered Nurse | 3635 S Harlem Ave, Berwyn, IL 60402-3212 | 2016-04-26 |
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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.