JOHN S ANDERSON (NPI# 1215387501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215387501 |
| Entity Type | Individual |
| Full Name | JOHN S ANDERSON |
| Practice Address |
819 Bloomington Rd Champaign IL 61820-2101 |
| Practice Telephone | 2174035477 |
| Practice Fax Number | 2174035476 |
| Mailing Telephone | 2174035477 |
| Mailing Fax Number | 2174035476 |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2016-06-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019.030678 | IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386251551 | John David Anderson | In Home Supportive Care | 6904 Joseph Drive, Enon, OH 45323-1448 | 2020-09-30 |
| 1689207433 | John William Anderson | Pharmacist | 5580 Hwy 70, Marshall, NC 28753 | 2020-02-20 |
| 1760956197 | John Elmer Anderson | Specialist/Technologist | 2201 University Dr, Lemont Furnace, PA 15456-1025 | 2019-01-18 |
| 1780123216 | John Fred Anderson Jr. | Student in an Organized Health Care Education/Training Program | 17093 Palisades Cir, Pacific Palisades, CA 90272-2139 | 2017-02-16 |
| 1588080147 | John Anderson | Obstetrics & Gynecology | 520 Campus Rd, Wyomissing, PA 19610-2216 | 2014-03-06 |
| 1033457809 | John Charles Anderson | Hearing Instrument Specialist | 116 Pennton Ave Sw Ste D, Lenoir, NC 28645-4377 | 2013-01-29 |
| 1093008138 | John Anderson | Acupuncturist | 7427 Se Woodstock Blvd, Portland, OR 97206-5838 | 2011-05-24 |
| 1649578212 | John Littleton Anderson V | Marriage & Family Therapist | 4908 Valley Ridge Ave, Los Angeles, CA 90043-1029 | 2011-03-07 |
| 1770880817 | John Edward Anderson Jr. | Psychologist | 6600 Beachview Dr, 400, Rancho Palos Verdes, CA 90275-5877 | 2011-02-25 |
| 1235435637 | John David Anderson | Urology | 4469 Green Valley Road, Fairfield, CA 94534-1365 | 2011-02-02 |
| Street Address |
819 BLOOMINGTON RD |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61820-2101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992770192 | Community Health Improvement Center | Clinic/Center | 819 Bloomington Rd, Champaign, IL 61820-2101 | 2006-02-21 |
| 1376166264 | Carlos Rodolfo Bocanegra Cordova | Physician Assistant | 819 Bloomington Rd, Champaign, IL 61820-2101 | 2020-05-26 |
| 1992324941 | Ryan Jordan Minier | Physician Assistant | 819 Bloomington Rd, Champaign, IL 61820-2101 | 2020-04-10 |
| 1972136620 | Doug C Smith | Social Worker | 819 Bloomington Rd, Champaign, IL 61820-2101 | 2020-02-20 |
| 1316592637 | Carrie Elizabeth Keenan | Physician Assistant | 819 Bloomington Rd, Champaign, IL 61820-2101 | 2019-08-04 |
| 1093283954 | River Andres | Physician Assistant | 819 Bloomington Rd, Champaign, IL 61820-2101 | 2018-11-08 |
| 1992290449 | Kaitlyn Cornell | Social Worker | 819 Bloomington Rd, Champaign, IL 61820 | 2018-06-27 |
| 1255833695 | Marisol Chirinos Tito | Physician Assistant | 819 Bloomington Rd, Champaign, IL 61820-2101 | 2018-03-01 |
| 1841713450 | Shellane Marie Tangen | Nurse Practitioner | 819 Bloomington Rd, Champaign, IL 61820-2101 | 2017-07-25 |
| 1790176402 | Todd Richard Johnson | Nurse Practitioner | 819 Bloomington Rd, Champaign, IL 61820-2101 | 2015-02-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982217345 | Costco Wholesale Corporation | Pharmacy | 2002 N. Neil St., Champaign, IL 61820 | 2020-08-26 |
| 1255963583 | Jamey Richard Bailey | Social Worker | 701 Devonshire Drive, Bldg C, Suite 206, C-6, Champaign, IL 61820 | 2020-02-05 |
| 1790247443 | Jason Abrams | Counselor | 201 W Springfield Ave., Suite 1002-1003, Champaign, IL 61820 | 2019-04-02 |
| 1184100273 | Janine Rafferty | Pharmacist | 2002 N Neil St, Champaign, IL 61820 | 2018-07-12 |
| 1417475070 | Brodbeck Counseling, PC | Community/Behavioral Health | 301 N. Neil Street Suite 323, Champaign, IL 61820 | 2017-09-05 |
| 1447773726 | Quanata M Pelmore | Nurse's Aide | 508 E. Vine St, Champaign, IL 61820 | 2017-07-19 |
| 1821518127 | Molly Mclay | Social Worker | 309 W Clark St., Champaign, IL 61820 | 2017-06-27 |
| 1396265849 | Lou Echols Chambers | Audiologist | 901 South Sixth Street, Chamapign, IL 61820 | 2017-06-26 |
| 1962874495 | Luciana Angelica Guardini | Social Worker | 100 North Chestnut Street, Suite 244, Champaign, IL 61820 | 2015-10-23 |
| 1538544465 | Cpo Services, Inc. | Prosthetic/Orthotic Supplier | 410 E University Ave Ste 105, Champaign, IL 61820 | 2015-07-21 |
| Find all providers in zip 61820 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295268019 | Mountain Bay Dental LLC | Dentist | 3510 Marianna Dr, Champaign, IL 61822-9502 | 2017-04-08 |
| 1982094462 | Familia Dental Champaign LLC | Dentist | 1907 W Spfld Ave, Champaign, IL 61821-3067 | 2015-02-04 |
| 1205245693 | Illini Smiles Dental Care PC | Dentist | 201 W Springfield Ave Ste 506, Champaign, IL 61820-6383 | 2014-08-11 |
| 1306152806 | Tania G Lodhi | Dentist | 1902 N Prospect Ave, Suite 1, Champaign, IL 61822-1411 | 2010-08-23 |
| 1154651628 | Michael R Ruffatto | Dentist | 1202 Harrington Dr, Champaign, IL 61821-6514 | 2010-01-06 |
| 1407005879 | Promise Healthcare Nfp | Dentist | 819 Bloomington Road, Champaign, IL 61820 | 2008-09-10 |
| 1851540330 | Central Illinois Oral and Maxiofacial Surgery, PC | Dentist | 14 E Anthony Dr Ste C, Champaign, IL 61820-2749 | 2008-09-09 |
| 1407002165 | Nikkole Patterson | Dentist | 3101 Village Office Pl, Champaign, IL 61822-7673 | 2008-08-13 |
| 1407010176 | Douglas M Wallen | Dentist | 2502 Galen Dr, Suite 103, Champaign, IL 61821-7045 | 2008-07-11 |
| 1275703175 | Thomas E. Standley, Dmd, PC | Dentist | 30 E Green St, Suite 1, Champaign, IL 61820-7905 | 2008-03-06 |
| Find all providers in CHAMPAIGN | ||||
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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.