MACY L HENSON (NPI# 1336605237) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336605237 |
| Entity Type | Individual |
| Full Name | MACY L HENSON |
| Credential | PA-C |
| Practice Address |
305 W Jackson St Ste 200 Carbondale IL 62901-1474 |
| Practice Telephone | 6185366621 |
| Practice Fax Number | 6184531102 |
| Mailing Telephone | 6185366621 |
| Mailing Fax Number | 6184531102 |
| Enumeration Date | 2019-02-15 |
| Last Update Date | 2019-02-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
085-006790 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
305 W JACKSON ST STE 200 |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901-1474 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073599767 | Erhime T Badejo | Registered Nurse | 305 W Jackson St Ste 200, Carbondale Family Medicine, Carbondale, IL 62901-1474 | 2005-12-15 |
| 1972165918 | Andrew Jeffry Vanscoyk | Family Medicine | 305 W Jackson St Ste 200, Carbondale, IL 62901-1474 | 2019-06-30 |
| 1720649858 | David Heath Trahan | Family Medicine | 305 W Jackson St Ste 200, Carbondale, IL 62901-1474 | 2019-06-28 |
| 1407416308 | Nicole Poythress Waters | Family Medicine | 305 W Jackson St Ste 200, Carbondale, IL 62901-1474 | 2019-06-13 |
| 1548827124 | Max Crouse | Family Medicine | 305 W Jackson St Ste 200, Carbondale, IL 62901-1474 | 2019-05-20 |
| 1821583964 | Dois Charles Ogan | Family Medicine | 305 W Jackson St Ste 200, Carbondale, IL 62901-1474 | 2018-06-29 |
| 1396239455 | Nicole Gyasi | Family Medicine | 305 W Jackson St Ste 200, Carbondale, IL 62901-1474 | 2018-06-21 |
| 1578057873 | Sohaib Sajjad | Family Medicine | 305 W Jackson St Ste 200, Carbondale, IL 62901-1474 | 2018-06-20 |
| 1285128504 | Charelle Octavia Smith | Family Medicine | 305 W Jackson St Ste 200, Carbondale, IL 62901-1474 | 2018-06-20 |
| 1649764812 | John Lindblom | Family Medicine | 305 W Jackson St Ste 200, Carbondale, IL 62901-1474 | 2018-06-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659741312 | Morgan Echols | Physician Assistant | 405 W Jackson St, Carbondale, IL 62901-1462 | 2015-10-06 |
| 1164774261 | Theresa Micknick | Physician Assistant | 165 Fallbrook St, Carbondale, PA 18433 | 2012-10-12 |
| 1255618237 | Alexis Elizabeth Lorinskas | Physician Assistant | 202 W Jackson St, Carbondale, IL 62901-1409 | 2011-11-04 |
| 1093025272 | Ann Bridget Diehl | Physician Assistant | 254 Brooklyn St, Carbondale, PA 18407-2824 | 2010-10-20 |
| 1225364219 | Alicia K Cremeens | Physician Assistant | 2601 W Main St, Carbondale, IL 62901-1031 | 2009-10-26 |
| 1376673582 | Ivy Jane Chalmers | Physician Assistant | 978 Euclid Ave, Carbondale, CO 81623-1820 | 2007-03-06 |
| 1962549790 | Jenifer Marie Chambless | Physician Assistant | 305 W Jackson St, Suite 200, Carbondale, IL 62901-1474 | 2007-01-31 |
| 1679511281 | Mary Rosenhauer | Physician Assistant | 1350 Cedar Ct, Carbondale, IL 62901-5336 | 2006-06-04 |
| 1972589919 | Max A Baier | Physician Assistant | 305 W Jackson St, Suite 200, Carbondale, IL 62901-1474 | 2005-12-21 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
Please comment or provide details below to improve the information on MACY L HENSON.
| 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.