QUINCY PHYSICIANS & SURGEONS CLINIC, SC (NPI# 1215497730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1215497730 |
Entity Type | Organization |
Organization Name | QUINCY PHYSICIANS & SURGEONS CLINIC, SC |
Practice Address |
1025 Maine St Quincy IL 62301-4096 |
Practice Telephone | 2172226550 |
Mailing Telephone | 2172226550 |
Enumeration Date | 2019-03-21 |
Last Update Date | 2019-03-21 |
Authorized Official Name | PATTY WOERMAN (CREDENTIALING SPECIALIST) |
Authorized Official Telephone | 2172226550 |
Is Organization Subpart | Y |
Parent Organization Name | QUINCY PHYSICIANS & SURGEONS CLINIC, SC |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | Suppliers |
Other Name | Type Code |
---|---|
Quincy Medical Group | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245862002 | Quincy Physicians & Surgeons Clinic, Sc | Clinic/Center | 3301 Broadway St., Quincy, IL 62301 | 2020-02-10 |
1861986549 | Quincy Physicians & Surgeons Clinic, Sc | Internal Medicine | 3347 Broadway St, Quincy, IL 62301 | 2018-06-18 |
1144462490 | Quincy Physicians & Surgeons Clinic, Sc | Clinic/Center | 1000 Central Street, Labelle, MO 63447 | 2009-04-01 |
1467426585 | Quincy Physicians & Surgeons Clinic, Sc | Clinic/Center | 405 E State, Pleasant Hill, IL 62366-0427 | 2006-02-15 |
1356315899 | Quincy Physicians & Surgeons Clinic, Sc | Clinic/Center | 320 North Madison, Pittsfield, IL 62363-1412 | 2006-02-13 |
1902870439 | Quincy Physicians & Surgeons Clinic, Sc | Clinic/Center | 1100 E Outer Rd S Ste 4, Canton, MO 63435-1702 | 2006-02-13 |
1639711120 | Quincy Physicians & Surgeons Clinic, Sc | Clinical Medical Laboratory | 320 N Madison St, Pittsfield, IL 62363-1412 | 2019-10-16 |
1508356098 | Quincy Physicians & Surgeons Clinic, Sc | Clinic/Center | 1603 Morgan St Ste 3, Keokuk, IA 52632-3433 | 2018-05-10 |
1790158087 | Quincy Physicians & Surgeons Clinic, Sc | Durable Medical Equipment & Medical Supplies | 100 Medical Dr, Hannibal, MO 63401-6877 | 2015-11-09 |
1851608780 | Quincy Physicians & Surgeons Clinic, Sc | Clinic/Center | 1025 Maine St, Quincy, IL 62301-4038 | 2010-09-14 |
Street Address |
1025 MAINE ST |
City | QUINCY |
State | IL |
Zip Code | 62301-4096 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205833860 | Don Manarang | Family Medicine | 1025 Maine St, Quincy, IL 62301-4038 | 2005-06-28 |
1518571546 | Amy E Durst | Nurse Practitioner | 1025 Maine St, Quincy, IL 62301-4096 | 2020-09-08 |
1477178820 | Bradley Allen Staten | Physician Assistant | 1025 Maine St, Quincy, IL 62301-4038 | 2020-06-11 |
1316586613 | Shari W Robesky | Social Worker | 1025 Maine St, Quincy, IL 62301-4038 | 2020-01-03 |
1154968675 | Erica A Fitzgerald | Nurse Practitioner | 1025 Maine St, Quincy, IL 62301-4096 | 2019-12-03 |
1366088007 | Paul D Warning | Counselor | 1025 Maine St, Quincy, IL 62301-4096 | 2019-11-18 |
1457902884 | Alison J Simmons | Occupational Therapist | 1025 Maine St, Quincy, IL 62301-4096 | 2019-09-26 |
1841847464 | Sarah J Thacker | Registered Nurse | 1025 Maine St, Quincy, IL 62301-4096 | 2019-08-19 |
1740832252 | Olivia P Rees | Dietitian, Registered | 1025 Maine St, Quincy, IL 62301-4096 | 2019-07-15 |
1386206795 | Luke A Ellerman | Nurse Practitioner | 1025 Maine St, Quincy, IL 62301-4038 | 2019-07-05 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356969471 | Lutheran Child and Family Service of Illinois | Foster Care Agency | 1400 N. 30th St, Quincy, IL 62301 | 2020-07-07 |
1134749716 | Bethany Nicole Jumps | Pharmacist | Broadway St & N 11th St, Quincy, IL 62301 | 2020-04-23 |
1043844293 | S.crider Construction An Supply Corp. | Contractor | 529 Woodbridge Dr., Quincy, IL 62301 | 2020-02-26 |
1245862002 | Quincy Physicians & Surgeons Clinic, Sc | Clinic/Center | 3301 Broadway St., Quincy, IL 62301 | 2020-02-10 |
1043851488 | West Central Illinois Nutrition | In Home Supportive Care | 639 York St. Room 333, Quincy, IL 62301 | 2019-10-07 |
1861986549 | Quincy Physicians & Surgeons Clinic, Sc | Internal Medicine | 3347 Broadway St, Quincy, IL 62301 | 2018-06-18 |
1194255083 | Michael Andrew Behrens | Nurse Practitioner | Broadway and 11th Street, Quincy, IL 62301 | 2017-06-14 |
1770987323 | Kirsty Yvonne Reed | Counselor | 205 S. 24th Street, Chaddock, Quincy, IL 62301 | 2014-10-10 |
1114234499 | Dale D. Shahan Dds Ltd | Dentist | 636 Hampshire Suite 102, Quincy, IL 62301 | 2010-09-08 |
1730314071 | James D Kaufmann | Pharmacist | 14th & Broadway, Quincy, IL 62301 | 2009-05-15 |
Find all providers in zip 62301 |
Taxonomy Code | 335V00000X |
Grouping | Suppliers |
Classification | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier |
A supplier that provides one or more of the following portable services, including but not limited to, x-ray, electrocardiogram (EKG), long-term EKG (Holter Monitor), bone densitometry, sonography, and other imaging services in accordance with all state and federal requirements, under the general supervision of a qualified physician. All necessary resources are transported to the patient's location where the services are performed. |
Notes: Source: National Uniform Claim Committee, 2015 [1/1/2016: title and definition modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467050849 | Starmed Diagnostics Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 222 E Wisconsin Ave Ste 2b, Lake Forest, IL 60045-1701 | 2020-10-16 |
1093313785 | Compuray Staffing | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 121 N Cross St Unit 346, Wheaton, IL 60187-5361 | 2020-10-14 |
1366050577 | Apex Portable X-ray Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 126 S. 4th St., Unit C Suite 1, Dekalb, IL 60115-3705 | 2020-07-14 |
1821615063 | Xoom Diagnostics | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 3916 W Lunt Ave, Lincolnwood, IL 60712-2534 | 2020-07-04 |
1164059572 | Northshore Ultrasound Services Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 215 S Edward St, Mt Prospect, IL 60056-3415 | 2020-03-25 |
1689149882 | Biomedical Imaging LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 2044 Madison Ave Ste 28, Granite City, IL 62040-4661 | 2018-10-04 |
1487151783 | Advanced Digital Mobile Xray Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 109 N Main St Rm D, Toluca, IL 61369-9430 | 2018-04-12 |
1699282145 | Medical Imaging Specialist Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 9944 S Roberts Rd Ste 106, Palos Hills, IL 60465-1555 | 2018-01-05 |
1639695257 | Go Diagnostics Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 5862 N Lincoln Ave, Suite 4, Chicago, IL 60659 | 2017-08-15 |
1386166049 | Diagnostic Vascular Testing, Inc. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 94 Sapphire Pt, Morton, IL 61550-3608 | 2017-07-13 |
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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.