JAIME HUMBERTO CERCONE (NPI# 1295804722) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295804722 |
| Entity Type | Individual |
| Full Name | JAIME HUMBERTO CERCONE |
| Credential | M.D. |
| Practice Address |
501 W Milton Ave Lewistown IL 61542-1322 |
| Practice Telephone | 3095472135 |
| Practice Fax Number | 3095471560 |
| Mailing Telephone | 3095472135 |
| Mailing Fax Number | 3095471560 |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 166124 | 05 |
| Street Address |
501 W MILTON AVE |
| City | LEWISTOWN |
| State | IL |
| Zip Code | 61542-1322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528379906 | County of Fulton | Public Health or Welfare | 100 N Main St, Lewistown, IL 61542-0111 | 2010-06-30 |
| 1942489745 | Harry E Burch | Chiropractor | 510 N Main St, Lewistown, IL 61542-1143 | 2007-10-29 |
| 1326040866 | James Victor Burch | Chiropractor | 510 N Main St, Lewistown, IL 61542-1143 | 2005-08-15 |
| 1598767576 | Burch Chiropractic Ltd | Chiropractor | 510 N Main St, Lewistown, IL 61542-1143 | 2005-08-10 |
| 1184064156 | R & Q Corporation | Pharmacy | 193 S Main St, Lewistown, IL 61542-1412 | 2013-07-05 |
| 1417092099 | Main Street Pharmacy Inc | Pharmacy | 195 S Main St, Lewistown, IL 61542-1412 | 2007-02-21 |
| 1144363573 | Main Street Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 195 S Main St, Lewistown, IL 61542-1412 | 2007-02-15 |
| 1750527172 | Graham Hospital Association | Family Medicine | 408 S. Main Street, Lewistown, IL 61542-1563 | 2009-01-07 |
| 1588758700 | Gretchen Wayne Fawcett | Physician Assistant | 408 S Main St, Lewistown, IL 61542-1563 | 2006-10-03 |
| 1841558012 | Niemann Foods Inc | Pharmacy | 518 S Main St, Lewistown, IL 61542-1565 | 2012-04-25 |
| Find all providers in zip 61542 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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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.