JOHN RYAN WILLIS (NPI# 1326095670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326095670 |
| Entity Type | Individual |
| Full Name | JOHN RYAN WILLIS |
| Credential | MD |
| Practice Address |
1 Good Samaritan Way Mount Vernon IL 62864-2402 |
| Mailing Address |
Mid America Radiology Sc Po Box 66971 Dept Mr St Louis MO 63166-6971 |
| Practice Telephone | 6182424600 |
| Mailing Telephone | 3034650401 |
| Mailing Fax Number | 3034381351 |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2016-07-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
36108723 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | RAILROAD ST JOE & UTLAH | P00077831 | 01 |
| IL | 036108723-3 | 05 | |
| IL | RAILROAD GOOD SAM & ST MARY'S | P00040956 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922355155 | John Churchill Willis IIi | Internal Medicine | 823 Weeden Island Dr, Niceville, FL 32578-3724 | 2012-08-07 |
| 1700021425 | John Glen Willis | Counselor | 1030 Johnson Rd Ste 286, Golden, CO 80401-6003 | 2008-12-09 |
| 1215093018 | John M Willis | Dentist | 6 Fundy Rd, Falmouth, ME 04105-1705 | 2006-12-28 |
| 1205891207 | John M Willis | Internal Medicine | 2800 E Broad St Ste 512, Mansfield, TX 76063-6417 | 2006-04-20 |
| 1356310577 | John Curtis Willis | Chiropractor | 305 Allegheny St, Richlands, VA 24641 | 2006-03-17 |
| 1548253172 | John A Willis | Orthopaedic Surgery | 130 N Street Ext, Hyannis, MA 02601-3825 | 2005-08-30 |
| 1063952190 | John Willis | Counselor | 22 Old Canal Dr, Lowell, MA 01851-2730 | 2017-03-08 |
| 1205211208 | John Macphee Willis | Dentist | 160 E. Erie Ave, St. Christopher's Hospital for Children, Attn: Dental, Philadelphia, PA 19134 | 2015-07-21 |
| 1619393493 | John Willis | Pharmacist | 1401 Minnesota Ave, Libby, MT 59923-2309 | 2014-03-17 |
| 1356763791 | John Willis | Pharmacist | 6131 E Southern Ave, Mesa, AZ 85206-3732 | 2014-01-18 |
| Street Address |
1 GOOD SAMARITAN WAY |
| City | MOUNT VERNON |
| State | IL |
| Zip Code | 62864-2402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083609184 | Kent S Quinn | Radiology | 1 Good Samaritan Way, Attn Radiology Dept, Mount Vernon, IL 62864-2402 | 2005-09-14 |
| 1407470206 | Brittany L Jerger | Registered Nurse | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2020-06-08 |
| 1407418619 | Annie Rae Lowery | Registered Nurse | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2019-07-08 |
| 1366951436 | Roxanna Elise Stevens | Nurse Practitioner | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2017-09-21 |
| 1871022095 | Mathavi Sahadevan | Internal Medicine | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2017-06-09 |
| 1326589680 | Amber Dawn Willis | Nurse Practitioner | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2017-03-19 |
| 1194269597 | Good Samaritan Regional Health Center | Anesthesiology | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2016-12-05 |
| 1710439112 | Nicole Michelle Boyd | Nurse Practitioner | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2016-11-01 |
| 1588115810 | Cristina Myers | Nurse Practitioner | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2016-10-21 |
| 1144771692 | Misty Dawn Wernsman | Nurse Practitioner | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2016-10-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619438892 | Melissa Pryer | Dietitian, Registered | 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 | 2019-03-28 |
| 1487145454 | Chiropractic Wellness Center of Mt Vernon, LLC. | Chiropractor | 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 | 2018-05-24 |
| 1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
| 1871907790 | University Hematology Oncology Inc | Specialist | #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 | 2014-06-18 |
| 1457771677 | Dynamic Counseling and Consultation Services | Social Worker | 3600 S Water Tower Pl, Mt Vernon, IL 62864 | 2014-04-27 |
| 1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
| 1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
| 1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
| 1780978627 | Jamie M Orange | Physical Therapy Assistant | 19958 Fairfield Rd, Mt. Vernon, IL 62864 | 2011-06-08 |
| 1780978791 | Wendy Marie Claytor | Speech-Language Pathologist | 600 E Il Hwy 15, Mount Vernon, IL 62864 | 2011-06-07 |
| Find all providers in zip 62864 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962624064 | Cumberland Radiology Psc | Radiology | 145 Perciful St, Mount Vernon, KY 40456-2740 | 2007-05-02 |
| 1932218757 | Skagit Radiology Inc Ps | Radiology | 1415 E Kincaid, Mount Vernon, WA 98274-4196 | 2006-08-29 |
| 1861455198 | Kimberley Sloan Miller | Radiology | 23144 Buchanan St, Mount Vernon, WA 98273-8031 | 2006-04-08 |
| 1295708949 | Lori A Ahrens | Radiology | 1320 E Division, Mount Vernon, WA 98274-4196 | 2006-02-10 |
| 1952371205 | Vicente A Gueco | Radiology | 4227 Lincolnshire Dr, Mount Vernon, IL 62864-2157 | 2006-01-26 |
| 1629049952 | Heartland Radiology Associates Ltd | Radiology | 4227 Lincolnshire Drive, Mount Vernon, IL 62864-2157 | 2006-01-26 |
| 1780673681 | Kevin C Wright | Radiology | 3614 Victoria Ave, Mount Vernon, IL 62864-2208 | 2005-10-14 |
| 1033103007 | Kenneth R Dee | Radiology | 12 N 7th Ave, Mount Vernon, NY 10550-2026 | 2005-09-07 |
| 1548619984 | Bh Imaging Consulting Pllc | Radiology | 145 Newcomb Ave, Mount Vernon, KY 40456-2728 | 2016-06-07 |
| 1477970382 | Andrew Philip Robbins | Radiology | 1320 E Division St, Mount Vernon, WA 98274-4133 | 2014-03-28 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 62864 |
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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.