DR. JENNIFER ANNE LOETHEN (NPI# 1205039955) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205039955 |
| Entity Type | Individual |
| Full Name | DR. JENNIFER ANNE LOETHEN |
| Credential | M.D. |
| Practice Address |
5 Professional Park Dr Maryville IL 62062-5621 |
| Mailing Address |
3165 Myrtle Ave Granite City IL 62040-5012 |
| Practice Telephone | 6188762924 |
| Mailing Telephone | 3096486024 |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2010-06-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 036121965 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036121965 | 05 |
| Street Address |
5 PROFESSIONAL PARK DR |
| City | MARYVILLE |
| State | IL |
| Zip Code | 62062-5621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104325091 | Jennifer M Oyler | Physician Assistant | 6812 State Route 162 Suite 120, Maryville, IL 62062 | 2018-02-06 |
| 1710495965 | Sarah Elizabeth Barto | Family Medicine | 2133 Vadalabene Drive, Suite Sb, Maryville, IL 62062 | 2018-01-22 |
| 1104348085 | Lindsey Nicole Langendorf | Chiropractor | 62 Executive Plaza Ct, Maryville, IL 62062 | 2017-07-12 |
| 1043750540 | Gina Saal | Nurse Anesthetist, Certified Registered | 6800 Rt 162, Maryville, IL 62062 | 2017-03-02 |
| 1548657737 | Karen Michelle Bertels | Emergency Medicine | 6800 Il - 162, Maryville, IL 62062 | 2015-04-25 |
| 1811258148 | Debra Ann Hoelscher | Internal Medicine | 2102 Vadalabene, Maryville, IL 62062 | 2012-06-04 |
| 1538438445 | Casey Elizabeth Wiesemeyer | Speech-Language Pathologist | 2201 Copper Creek Rd, Maryville, IL 62062 | 2011-12-21 |
| 1407144819 | Norah Claire Farley Baker | Family Medicine | 10 Professional Park Dr., Maryville, IL 62062 | 2011-07-19 |
| 1891092474 | Kimberly M Schneider | Physician Assistant | 20b Professional Park Drive, Maryville, IL 62062 | 2011-02-17 |
| 1669782397 | Purandhri Patel | Physical Therapist | 6820 State Route 162, Maryville, IL 62062 | 2010-10-15 |
| Find all providers in zip 62062 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134677818 | Dixie Swanson | Pediatrics | 2705 Daventry Dr, Maryville, TN 37804-6141 | 2016-09-12 |
| 1659422053 | Cynthia J Easter | Pediatrics | 681 Morganton Square Dr, Maryville, TN 37801-4763 | 2007-01-15 |
| 1326125428 | Blount Memorial Hospital, Inc. | Pediatrics | 212 Cates St, Maryville, TN 37801-4902 | 2006-11-01 |
| 1700807187 | Habibur Rahman | Pediatrics | 6828 State Route 162, Suite A, Maryville, IL 62062-8500 | 2006-07-21 |
| 1811921026 | Whitney Elizabeth Dee | Pediatrics | 616 W Lamar Alexander Pkwy, Maryville, TN 37801-3904 | 2006-07-11 |
| 1093744872 | Cindy Elaine Hoover | Pediatrics | 414 Greenbelt Dr, Maryville, TN 37804-5702 | 2006-07-02 |
| 1669416921 | Lori A Baxter | Pediatrics | Cedar Creek Pediatric & Adolescent Medicine, PC, 616 Smithview Drive, Maryville, TN 37803-6100 | 2006-06-16 |
| 1467613430 | Jenna Kathleen Neil Mccall | Pediatrics | 414 Greenbelt Dr, Maryville, TN 37804-5702 | 2008-06-22 |
| 1851591523 | Jennifer Dawn Krick | Pediatrics | 6828 State Route 162, Maryville, IL 62062-8500 | 2007-07-20 |
| 1003039223 | Cedar Creek Pediatric & Adolescent Medicine, PC | Pediatrics | 616 Smithview Dr, Maryville, TN 37803-6100 | 2007-04-10 |
| Find all providers in MARYVILLE | ||||
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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.