MR. JASON D CHURCHILL (NPI# 1265592455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265592455 |
| Entity Type | Individual |
| Full Name | MR. JASON D CHURCHILL |
| Credential | PA |
| Practice Address |
1306 Maple St Eldorado IL 62930-1662 |
| Mailing Address |
510 Lincoln Dr Herrin IL 62948-6334 |
| Practice Telephone | 6182733361 |
| Practice Fax Number | 6182732504 |
| Mailing Telephone | 6189974310 |
| Mailing Fax Number | 6189989635 |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2019-02-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
2006030653 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
085-002808 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 510 Lincoln Dr, Herrin, IL 629486334 | 6189974310 | 6189989635 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922631621 | Jason Churchill | Marriage & Family Therapist | 1433 S Robertson Blvd, Los Angeles, CA 90035-3414 | 2020-02-20 |
| Street Address |
1306 MAPLE ST |
| City | ELDORADO |
| State | IL |
| Zip Code | 62930-1662 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902886583 | Christopher Greater Area Rural Health Planning Corp | Family Medicine | 1306 Maple St, Doctors Clinic, Eldorado, IL 62930 | 2006-01-19 |
| 1346711553 | Meghan A Mitchell | Nurse Practitioner | 1306 Maple St, Eldorado, IL 62930-1662 | 2018-12-16 |
| 1194207258 | Caitlyn E Karns | Nurse Practitioner | 1306 Maple St, Eldorado, IL 62930 | 2018-09-05 |
| 1124561394 | Emily E Goemaat | Nurse Practitioner | 1306 Maple St, Eldorado, IL 62930-1662 | 2016-11-21 |
| 1154691319 | Casey L Carlile | Nurse Practitioner | 1306 Maple St, Eldorado, IL 62930 | 2012-01-05 |
| 1013299395 | Ferrell Hospital Community Foundation | Clinic/Center | 1306 Maple St, Eldorado, IL 62930-1662 | 2011-09-13 |
| 1306074042 | Ferrell Hospital Family Practice | Clinic/Center | 1306 Maple St, Eldorado, IL 62930-1662 | 2009-07-01 |
| 1457586620 | Ferrell Hospital Community Foundation | General Practice | 1306 Maple St, Eldorado, IL 62930-1662 | 2009-05-18 |
| 1922259993 | Linda Redick | Physician Assistant | 1306 Maple St, Eldorado, IL 62930-1662 | 2008-10-08 |
| 1649353160 | Jacquelyn Dortch | Licensed Practical Nurse | 1306 Maple St, Doctors Clinic, Eldorado, IL 62930 | 2006-10-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164951802 | Jeanette Long X | Licensed Practical Nurse | 70 Alexander St, Eldorado, IL 62930 | 2017-06-07 |
| 1720510514 | Mckayla Addison Wren | Counselor | 1412 Us. 45n, Eldorado, IL 62930 | 2017-03-30 |
| 1407394901 | Melody Jo Smith | Licensed Practical Nurse | 2260 Raleigh Road, Eldorado, IL 62930 | 2017-02-03 |
| 1205250412 | Becks Long Term Care Pharmacy Inc | Pharmacy | 1413 Locust Street, Eldorado, IL 62930 | 2014-02-07 |
| 1346559283 | Danny Ray Phillips | Pharmacist | 1021 Us Hwy 45 North, Eldorado, IL 62930 | 2010-09-27 |
| 1447434477 | Elana Ruth Floyd-kennett | Social Worker | 1007 Route 45, Eldorado, IL 62930 | 2007-12-27 |
| 1417150376 | Luke Tyler Hall | Family Medicine | 1407 Locust St, Eldorado, IL 62930 | 2007-06-07 |
| 1134320039 | Eldorado Community Unit School District #4 | Local Education Agency (LEA) | 1040 Washington, Eldorado, IL 62930 | 2007-05-29 |
| 1013071026 | Marion Eye Centers Ltd. | Durable Medical Equipment & Medical Supplies | 1204 U.S. 45 N., Eldorado, IL 62930 | 2006-12-21 |
| 1467536557 | Debra Dian Rumsey | Licensed Practical Nurse | 607 4th Street, Eldorado Rural Health Clinic, Eldorado, IL 62930 | 2006-10-25 |
| Find all providers in zip 62930 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831707298 | Eliza Ballen | Physician Assistant | 335 Sylvan Rd, Lake Bluff, IL 60044-2562 | 2020-07-21 |
| 1477177947 | Rybecca Janovyak | Physician Assistant | 14432 High Rd, Lockport, IL 60441-9402 | 2020-06-01 |
| 1518591759 | Julie Jenkot | Physician Assistant | 333 N Michigan Ave Fl 14, Chicago, IL 60601-3901 | 2020-02-26 |
| 1801429873 | Hinjal D Jha | Physician Assistant | 22285 N Pepper Rd Ste 409, Lake Barrington, IL 60010-2542 | 2020-02-19 |
| 1770120222 | Alvina Shaikh | Physician Assistant | 4009 Warren Ave, Bellwood, IL 60104-2066 | 2019-12-03 |
| 1457997561 | Jasleen Mohini Singh | Physician Assistant | 1645a W School Street, Suite A, Clinic Entrance, Chicago, IL 60657 | 2019-11-24 |
| 1538705272 | Bethany Mae Frisby | Physician Assistant | 8630 W Golf Rd, Niles, IL 60714-5600 | 2019-11-18 |
| 1134761984 | Ella-marie Rakowski | Physician Assistant | 25 Acorn Dr, Hawthorn Woods, IL 60047-7407 | 2019-10-14 |
| 1467001859 | Timothy Omotayo Adesanya | Physician Assistant | Graham Correctional Center, 12078 Illinois Rte 185, Hilliboro, IL 62049 | 2019-09-09 |
| 1518514066 | Victoria Moore | Physician Assistant | 979 W Main St, West Dundee, IL 60118-2088 | 2019-08-20 |
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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.