MR. JUSTIN L NORTHCUTT (NPI# 1194351668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194351668 |
| Entity Type | Individual |
| Full Name | MR. JUSTIN L NORTHCUTT |
| Credential | PA-C |
| Practice Address |
8 Doctors Park Rd Mount Vernon IL 62864-6224 |
| Mailing Address |
12415 Somerset Place Dr Apt J Saint Louis MO 63128-2243 |
| Practice Telephone | 6182445500 |
| Enumeration Date | 2020-03-17 |
| Last Update Date | 2020-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085007547 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
8 DOCTORS PARK RD |
| City | MOUNT VERNON |
| State | IL |
| Zip Code | 62864-6224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194729517 | James E. Probst Jr. | Anesthesiology | 8 Doctors Park Rd, Mount Vernon, IL 62864-6224 | 2005-06-13 |
| 1437719093 | Vincent Coty Compton | Nurse Anesthetist, Certified Registered | 8 Doctors Park Rd, Mount Vernon, IL 62864-6224 | 2019-06-17 |
| 1457824690 | Tyler Andrew Rueter | Nurse Practitioner | 8 Doctors Park Rd, Mount Vernon, IL 62864-6224 | 2019-01-10 |
| 1447778642 | Adit Shah | Urology | 8 Doctors Park Rd, Mount Vernon, IL 62864-6224 | 2017-09-07 |
| 1518391200 | National Radiology Group At Mt Vernon LLC | Radiology | 8 Doctors Park Rd, Mount Vernon, IL 62864-6224 | 2013-08-29 |
| 1972878460 | Anesthesia Associates of Southern Illinois, LLC | Anesthesiology | 8 Doctors Park Rd, Mount Vernon, IL 62864-6224 | 2012-03-15 |
| 1922333806 | Deborah M Kessler | Occupational Therapist | 8 Doctors Park Rd, Mount Vernon, IL 62864-6224 | 2009-10-09 |
| 1083803852 | Rend Emergency Physicians | Emergency Medicine | 8 Doctors Park Rd, Mount Vernon, IL 62864-6224 | 2007-10-17 |
| 1467668152 | B J Gee | Respiratory Therapist, Registered | 8 Doctors Park Rd, Mount Vernon, IL 62864-6224 | 2007-05-16 |
| 1063630820 | National Healthcare of Mt Vernon Inc | Emergency Medicine | 8 Doctors Park Rd, Mount Vernon, IL 62864-6224 | 2007-04-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619438892 | Melissa Pryer | Dietitian, Registered | 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 | 2019-03-28 |
| 1487145454 | Chiropractic Wellness Center of Mt Vernon, LLC. | Chiropractor | 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 | 2018-05-24 |
| 1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
| 1871907790 | University Hematology Oncology Inc | Specialist | #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 | 2014-06-18 |
| 1457771677 | Dynamic Counseling and Consultation Services | Social Worker | 3600 S Water Tower Pl, Mt Vernon, IL 62864 | 2014-04-27 |
| 1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
| 1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
| 1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
| 1780978627 | Jamie M Orange | Physical Therapy Assistant | 19958 Fairfield Rd, Mt. Vernon, IL 62864 | 2011-06-08 |
| 1780978791 | Wendy Marie Claytor | Speech-Language Pathologist | 600 E Il Hwy 15, Mount Vernon, IL 62864 | 2011-06-07 |
| Find all providers in zip 62864 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982249124 | Leticia B Barrientos | Physician Assistant | 472 Gramatan Ave Apt Bb4, Mount Vernon, NY 10552-2979 | 2019-11-12 |
| 1396390522 | Elizabeth Kuriakose | Physician Assistant | 203 Gramatan Ave Ste A, Mount Vernon, NY 10550-1291 | 2019-08-05 |
| 1174941728 | Lyndsey Switzer | Physician Assistant | 1600 Continental Pl Ste 101, Mount Vernon, WA 98273-5607 | 2014-04-01 |
| 1255585311 | Pamela Welch | Physician Assistant | 5754 Farm Road 21, Mount Vernon, TX 75457-7749 | 2008-11-15 |
| 1881857787 | Telesforo Llamas Jr. | Physician Assistant | 2 Fisher Dr, Apartment 607, Mount Vernon, NY 10552-3666 | 2008-07-10 |
| 1275712614 | Naima R Abdus-salaam | Physician Assistant | 495 N Fulton Ave, Mount Vernon, NY 10552-1909 | 2007-11-02 |
| 1316006588 | Lee Barry Leavelle | Physician Assistant | 107 W 4th Street, Mount Vernon Neighborhood Health Ctr, Mount Vernon, NY 10550 | 2006-12-06 |
| 1215096359 | Patricia Taddeo | Physician Assistant | 107 West Fourth St, Mount Vernon Neighborhood Health Center, Mount Vernon, NY 10550 | 2006-12-06 |
| 1831270065 | Rochelle A, Trussell | Physician Assistant | 1400 E. Kincaid St, Mount Vernon, WA 98274-4127 | 2006-10-17 |
| 1750497061 | Shirley Dallmier | Physician Assistant | 3307 Broadway St Ste 130, Physician Rural Health Clinic of Jefferson County, Mount Vernon, IL 62864-2387 | 2006-08-21 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 62864 |
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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.