LINDENWOOD UNIVERSITY-BELLEVILLE (NPI# 1316499155) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316499155 |
| Entity Type | Organization |
| Organization Name | LINDENWOOD UNIVERSITY-BELLEVILLE |
| Other Organization Name | LINDENWOOD UNIVERSITY-BELLEVILLE SPORTS MEDICINE |
| Practice Address |
2600 W Main St Belleville IL 62226-6651 |
| Mailing Address |
5050 Spring Valley Rd. Dallas TX 75244-3909 |
| Practice Telephone | 9723674845 |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2016-10-27 |
| Authorized Official Name | MOUZON BASS III (AGENT) |
| Authorized Official Telephone | 9723674845 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
036129925 | IL | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Lindenwood University-Belleville Sports Medicine | Doing Business As Name - Organization |
| Street Address |
2600 W MAIN ST |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62226-6651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780233544 | Hailey Nicole Erdman | Specialist/Technologist | 2600 W Main St, Belleville, IL 62226-6651 | 2019-09-04 |
| 1588212583 | Sydney Christine Kremer | Specialist/Technologist | 2600 W Main St, Belleville, IL 62226-6651 | 2019-09-03 |
| 1043868193 | Heather Danielle Waldemar | Student in an Organized Health Care Education/Training Program | 2600 W Main St, Belleville, IL 62226-6651 | 2019-09-03 |
| 1952959009 | Diana Nicole Shamroski | Student in an Organized Health Care Education/Training Program | 2600 W Main St, Belleville, IL 62226-6651 | 2019-09-03 |
| 1174171201 | Payton Michelle Curtis | Specialist/Technologist | 2600 W Main St, Belleville, IL 62226-6651 | 2019-09-02 |
| 1851826481 | Lauren Randazzo | Specialist/Technologist | 2600 W Main St, Belleville, IL 62226-6651 | 2017-04-20 |
| 1700310026 | Seth Vilas | Specialist/Technologist | 2600 W Main St, Belleville, IL 62226-6651 | 2017-04-13 |
| 1043743545 | Tim Woodstock | Specialist/Technologist | 2600 W Main St, Belleville, IL 62226-6651 | 2017-04-11 |
| 1548613300 | Stephen Curtis Wilkerson | Specialist/Technologist | 2600 W Main St, Belleville, IL 62226-6651 | 2016-07-18 |
| 1699127720 | Jenalee Cologna | Specialist/Technologist | 2600 W Main St, Belleville, IL 62226-6651 | 2016-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1053969790 | Consistent Medical Transportation | Driver | 2012 N 17th St, Swansea, IL 62226 | 2019-08-27 |
| 1497314371 | Medi-plex Hospice of Illinois, LLC | Registered Nurse | 8 Park Place, Suite #3, Swansea, IL 62226 | 2019-06-13 |
| 1336617364 | Nicole Renee Schmidt | Speech-Language Pathologist | 150 N 27th St., Belleville, IL 62226 | 2018-11-07 |
| 1295258903 | Catherine Espino | Pharmacist | 11 Chambers Blvd, Swansea, IL 62226 | 2017-07-25 |
| 1366806838 | Kiley Faires | Nurse Practitioner | 4600 Memorial Drive Ste 360, Belleville, IL 62226 | 2016-04-11 |
| 1760857585 | Mvp Transportation | Non-emergency Medical Transport (VAN) | 1229 N 17th Street, Number 23, Belleville, IL 62226 | 2015-12-04 |
| 1275952566 | Aisha Danyale Franklin | Internal Medicine | 4261 Woodfield Pl, Belleville, IL 62226 | 2014-04-15 |
| 1396168332 | Jayne E. Ninness | Physical Therapy Assistant | 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 | 2014-01-28 |
| 1053758193 | Gateway Foundation, Inc. | Clinic/Center | 1 Bronze Point, Suite 1, Swansea, IL 62226 | 2013-05-30 |
| Find all providers in zip 62226 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184832255 | Frances Mary Rispoli | Orthopaedic Surgery | 426 Franklin Ave, Belleville, Belleville, NJ 07109-1503 | 2007-05-20 |
| 1841487808 | Orthopedics and Sports Medicine Specialty Care Limited Liability Co | Orthopaedic Surgery | 426 Franklin Ave, Belleville, NJ 07109-1503 | 2007-10-03 |
| 1558470617 | Michael S Hughes | Orthopaedic Surgery | 4700 Memorial Dr, Ste. 340, Belleville, IL 62226-5373 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063048395 | Dr Ouilife LLC | Orthopaedic Surgery | 640 S Federal St Apt 410, Chicago, IL 60605-1800 | 2020-03-18 |
| 1316437890 | Darcy L Marr | Orthopaedic Surgery | 3030 Salt Creek Lane, Suite 100, Arlington Heights, IL 60005 | 2018-05-10 |
| 1568851251 | Benjamin Scott Kester | Orthopaedic Surgery | 1725 W Harrison St Ste Rush, Chicago, IL 60612-3841 | 2015-01-18 |
| 1609041565 | Sheryl Lynn Lipnick | Orthopaedic Surgery | 1585 N. Barrington Rd Ste 101, Drs. Bldg. 2, Hoffman Estates, IL 60169-5019 | 2008-04-22 |
| 1295937555 | Gregory Lamar Primus | Orthopaedic Surgery | 7543 183rd St, Tinley Park, IL 60477-6208 | 2007-05-31 |
| 1154454635 | Benjamin Domb | Orthopaedic Surgery | 999 E Touhy Ave Ste 450, Des Plaines, IL 60018-2748 | 2007-03-13 |
| 1518981612 | Sean Daniel Odell | Orthopaedic Surgery | 375 S Roselle Rd, Schaumburg, IL 60193-5544 | 2006-07-26 |
| 1568419463 | Mark K. Bowen | Orthopaedic Surgery | 680 N Lake Shore Dr Ste 924, Chicago, IL 60611 | 2006-05-27 |
| 1639146103 | Jean Benoit Houle | Orthopaedic Surgery | 4121 Veterans Memorial Dr, Mount Vernon, IL 62864-6262 | 2006-03-03 |
| 1093792277 | Scott Eric Urch | Orthopaedic Surgery | 503 E Grant St, Macomb, IL 61455-3313 | 2005-12-28 |
| Find all providers with the same taxonomy | ||||
| City | BELLEVILLE |
| Zip Code | 62226 |
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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.