BRYAN J. KELLENBERGER (NPI# 1275733073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1275733073 |
Entity Type | Individual |
Full Name | BRYAN J. KELLENBERGER |
Credential | M.D. |
Practice Address |
400 Saint Johns Dr Sherman IL 62684-9779 |
Mailing Address |
1025 S 6th St Springfield IL 62703-2403 |
Practice Telephone | 2175287541 |
Practice Fax Number | 2175250044 |
Mailing Telephone | 2175287541 |
Mailing Fax Number | 2175250044 |
Enumeration Date | 2007-07-19 |
Last Update Date | 2020-05-21 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Q00000X | Family Medicine | 036125353 | IL | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | 036125353 | 05 |
Street Address |
400 SAINT JOHNS DR |
City | SHERMAN |
State | IL |
Zip Code | 62684-9779 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275633968 | Kenneth R. Sagins | Internal Medicine | 400 Saint Johns Dr, Sherman, IL 62684-9779 | 2006-09-23 |
1861905721 | Springfield Clinic LLP | Non-Pharmacy Dispensing Site | 400 Saint Johns Dr, Sherman, IL 62684-9779 | 2017-11-14 |
1659729002 | Ashley Rossi | Internal Medicine | 400 Saint Johns Dr, Sherman, IL 62684-9779 | 2016-05-26 |
1710145594 | Sherman Family Medical Center Lab | Clinical Medical Laboratory | 400 Saint Johns Dr, Sherman, IL 62684-9779 | 2008-05-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760994404 | Sarah Rae Wickenhauser | Nurse Practitioner | 2806 E Andrew Rd, Sherman, IL 62684 | 2017-11-03 |
1215229836 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 106 Illini Blvd, Sherman, IL 62684 | 2011-05-16 |
1609963214 | Leticia A. Drapiza | Family Medicine | 400 St. John's Drive, Sherman, IL 62684 | 2006-10-06 |
1366424723 | John P Folkerts | Chiropractor | 420 S Crossing Dr, Sherman, IL 62684 | 2005-11-18 |
1548386535 | Jill Noel Edwards | Speech-Language Pathologist | 485 Meredith Dr, Sherman, IL 62684-8180 | 2007-03-21 |
1225567936 | Taylor Edwards | Developmental Therapist | 485 Meredith Dr, Sherman, IL 62684-8180 | 2017-06-06 |
1659654218 | Sandra J Le | Pharmacist | 106 Illini Blvd, Sherman, IL 62684-8480 | 2011-09-21 |
1184134587 | Kathryn Elzerman | Pharmacist | 106 Illini Blvd, Sherman, IL 62684-8484 | 2017-10-11 |
1285934448 | Jennifer Relyea | Speech-Language Pathologist | 720 S 1st St, Sherman, IL 62684-9448 | 2010-10-21 |
1063971711 | Grayce Parker | Speech-Language Pathologist | 605 Stonehill Dr, Sherman, IL 62684-9504 | 2019-03-12 |
Find all providers in zip 62684 |
Taxonomy Code | 207Q00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619498490 | John Herman Roberts Jr. | Family Medicine | 1111 Gallaher Dr., Sherman, TX 75090 | 2017-06-30 |
1245780402 | Philip H. Yeilding P.C. | Family Medicine | 600 N Highland Ave Ste 108, Sherman, TX 75092-5631 | 2016-10-11 |
1366749301 | Enrique Muyshondt-contreras | Family Medicine | 1913 Stonebrook Ln, Sherman, TX 75092-6189 | 2011-02-25 |
1962637967 | Maria Alejandra Vallejo-nieto | Family Medicine | 2907 Overland Trl Ste 200, Sherman, TX 75092-4498 | 2009-05-19 |
1780808832 | Center for Family Medicine,pa | Family Medicine | 1906 Hwy 82 West, Sherman, TX 75092 | 2007-04-12 |
1598809741 | Grant Arnold Craig | Family Medicine | 2801 N Loy Lake Rd, Sherman, TX 75090-1726 | 2007-02-19 |
1225126469 | Christian A Cooper | Family Medicine | 1906 Hwy 82 W, Sherman, TX 75092 | 2006-10-11 |
1609963214 | Leticia A. Drapiza | Family Medicine | 400 St. John's Drive, Sherman, IL 62684 | 2006-10-06 |
1326050832 | Shawn Bryden Macdonald | Family Medicine | 2500 N Travis St, Sherman, TX 75092-2521 | 2006-08-13 |
1790711919 | Jennifer Laing | Family Medicine | 1000 South Heritage Pkwy, Sherman, TX 75092 | 2006-06-23 |
Find all providers in SHERMAN |
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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.